Provider Demographics
NPI:1134278054
Name:MEDICAL CARE ASSOCIATES
Entity type:Organization
Organization Name:MEDICAL CARE ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:DR
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:
Authorized Official - Last Name:HEPPERLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD, FRCP
Authorized Official - Phone:334-361-7404
Mailing Address - Street 1:645 MCQUEEN SMITH RD N
Mailing Address - Street 2:SUITE302
Mailing Address - City:PRATTVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36066-7268
Mailing Address - Country:US
Mailing Address - Phone:334-361-7404
Mailing Address - Fax:334-361-7863
Practice Address - Street 1:645 MCQUEEN SMITH RD N
Practice Address - Street 2:SUITE302
Practice Address - City:PRATTVILLE
Practice Address - State:AL
Practice Address - Zip Code:36066-7268
Practice Address - Country:US
Practice Address - Phone:334-361-7404
Practice Address - Fax:334-361-7863
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2008-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL20750174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000038657Medicaid
AL110155714OtherRAILROAD MEDICARE
AL04-10195OtherUNITED HEALTH CARE
ALHE000038657Medicaid
AL051038657HEPOtherBLUE CROSS BLUE SHEILD
ALHE000038657Medicaid
AL=========OtherTAX ID
AL110155714OtherRAILROAD MEDICARE
AL000038657Medicaid