Provider Demographics
NPI:1902033640
Name:NEW HOPE CHILDRENS CLINIC
Entity Type:Organization
Organization Name:NEW HOPE CHILDRENS CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:L
Authorized Official - Last Name:MCGOUGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-503-9112
Mailing Address - Street 1:5300 MAIN DR
Mailing Address - Street 2:
Mailing Address - City:NEW HOPE
Mailing Address - State:AL
Mailing Address - Zip Code:35760-9058
Mailing Address - Country:US
Mailing Address - Phone:256-529-7507
Mailing Address - Fax:
Practice Address - Street 1:5300 MAIN DR
Practice Address - Street 2:
Practice Address - City:NEW HOPE
Practice Address - State:AL
Practice Address - Zip Code:35760-9058
Practice Address - Country:US
Practice Address - Phone:256-529-7507
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-21
Last Update Date:2009-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare