Provider Demographics
NPI:1841384534
Name:LIMESTONE COMMUNITY CARE, INC
Entity Type:Organization
Organization Name:LIMESTONE COMMUNITY CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:AUBREY
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:256-732-3712
Mailing Address - Street 1:25565 LEVIE DAVIS DRIVE
Mailing Address - Street 2:P.O. BOX 449
Mailing Address - City:ELKMONT
Mailing Address - State:AL
Mailing Address - Zip Code:35620
Mailing Address - Country:US
Mailing Address - Phone:256-732-3712
Mailing Address - Fax:256-732-3714
Practice Address - Street 1:25565 LEVIE DAVIS DRIVE
Practice Address - Street 2:
Practice Address - City:ELKMONT
Practice Address - State:AL
Practice Address - Zip Code:35620
Practice Address - Country:US
Practice Address - Phone:256-732-3712
Practice Address - Fax:256-732-3714
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL19353363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALG18660Medicare UPIN