Provider Demographics
NPI:1518102912
Name:MINORMEDCARE, INC.
Entity Type:Organization
Organization Name:MINORMEDCARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:CAMPBELL
Authorized Official - Last Name:ROWLAND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:251-660-6155
Mailing Address - Street 1:5215 HIGHWAY 90 W
Mailing Address - Street 2:SUITE A
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36619-4230
Mailing Address - Country:US
Mailing Address - Phone:251-660-6155
Mailing Address - Fax:
Practice Address - Street 1:5215 HIGHWAY 90 W
Practice Address - Street 2:SUITE A
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36619-4230
Practice Address - Country:US
Practice Address - Phone:251-660-6155
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-13
Last Update Date:2008-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain