Provider Demographics
NPI:1972862837
Name:ATTENTUS MOULTON LLC
Entity Type:Organization
Organization Name:ATTENTUS MOULTON LLC
Other - Org Name:LAWRENCE RURAL HEALTH CLINIC/LAWRENCE URGENT CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LAW CO HEALTHCARE AUTH BD SECRETARY
Authorized Official - Prefix:MR
Authorized Official - First Name:BOBBY
Authorized Official - Middle Name:
Authorized Official - Last Name:DOVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-974-8839
Mailing Address - Street 1:10939 AL HIGHWAY 157
Mailing Address - Street 2:SUITE C
Mailing Address - City:MOULTON
Mailing Address - State:AL
Mailing Address - Zip Code:35650-1900
Mailing Address - Country:US
Mailing Address - Phone:256-974-6550
Mailing Address - Fax:256-974-6551
Practice Address - Street 1:10939 AL HIGHWAY 157
Practice Address - Street 2:SUITE C
Practice Address - City:MOULTON
Practice Address - State:AL
Practice Address - Zip Code:35650-1900
Practice Address - Country:US
Practice Address - Phone:256-974-6550
Practice Address - Fax:256-974-6551
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ATTENTUS-MOULTON LLC DBA LAWRENCE MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-05-14
Last Update Date:2013-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care