Provider Demographics
NPI:1619623915
Name:S.C.R.E.E.N.S. LLC
Entity Type:Organization
Organization Name:S.C.R.E.E.N.S. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:CLIFFORD
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:256-225-6737
Mailing Address - Street 1:212 E 28TH ST
Mailing Address - Street 2:
Mailing Address - City:ANNISTON
Mailing Address - State:AL
Mailing Address - Zip Code:36201-2930
Mailing Address - Country:US
Mailing Address - Phone:256-225-6737
Mailing Address - Fax:919-590-1895
Practice Address - Street 1:1400 COMMERCE BLVD STE 17
Practice Address - Street 2:
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36207-9454
Practice Address - Country:US
Practice Address - Phone:256-225-6737
Practice Address - Fax:919-590-1895
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-24
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty