Provider Demographics
NPI:1689342396
Name:ECURE, LLC
Entity Type:Organization
Organization Name:ECURE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHAWNTAVIA
Authorized Official - Middle Name:LATRICE
Authorized Official - Last Name:POWE
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:205-498-5519
Mailing Address - Street 1:120 19TH ST N STE 321
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35203-3234
Mailing Address - Country:US
Mailing Address - Phone:205-498-5519
Mailing Address - Fax:
Practice Address - Street 1:120 19TH ST N STE 321
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35203-3234
Practice Address - Country:US
Practice Address - Phone:205-498-5519
Practice Address - Fax:205-270-4001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-30
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care