Provider Demographics
NPI:1336475730
Name:HEMAPRO INC.
Entity Type:Organization
Organization Name:HEMAPRO INC.
Other - Org Name:MEDCARE EAST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FAMILY PRACTICE
Authorized Official - Prefix:DR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:J
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:256-233-5911
Mailing Address - Street 1:22281 US HIGHWAY 72
Mailing Address - Street 2:SUITE A
Mailing Address - City:ATHENS
Mailing Address - State:AL
Mailing Address - Zip Code:35613-2600
Mailing Address - Country:US
Mailing Address - Phone:256-233-5911
Mailing Address - Fax:256-233-5611
Practice Address - Street 1:22281 US HIGHWAY 72
Practice Address - Street 2:SUITE A
Practice Address - City:ATHENS
Practice Address - State:AL
Practice Address - Zip Code:35613-2600
Practice Address - Country:US
Practice Address - Phone:256-233-5911
Practice Address - Fax:256-233-5611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-20
Last Update Date:2009-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4217261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care