Provider Demographics
NPI:1467821777
Name:IMMEDIATE CARE FOLEY
Entity Type:Organization
Organization Name:IMMEDIATE CARE FOLEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:DYESS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:251-300-2770
Mailing Address - Street 1:1265 S MCKENZIE ST
Mailing Address - Street 2:
Mailing Address - City:FOLEY
Mailing Address - State:AL
Mailing Address - Zip Code:36535-1818
Mailing Address - Country:US
Mailing Address - Phone:251-923-4633
Mailing Address - Fax:251-971-5530
Practice Address - Street 1:1265 S MCKENZIE ST
Practice Address - Street 2:
Practice Address - City:FOLEY
Practice Address - State:AL
Practice Address - Zip Code:36535-1818
Practice Address - Country:US
Practice Address - Phone:251-923-4633
Practice Address - Fax:251-971-5530
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-16
Last Update Date:2015-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALDO734207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty