Provider Demographics
NPI:1265164537
Name:TRUECARE MEDICAL CLINIC, LLC
Entity type:Organization
Organization Name:TRUECARE MEDICAL CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:N
Authorized Official - Last Name:NOOJIN
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:256-601-6636
Mailing Address - Street 1:PO BOX 680622
Mailing Address - Street 2:
Mailing Address - City:FORT PAYNE
Mailing Address - State:AL
Mailing Address - Zip Code:35968-1607
Mailing Address - Country:US
Mailing Address - Phone:256-364-8875
Mailing Address - Fax:256-364-8875
Practice Address - Street 1:613 GAULT AVE S
Practice Address - Street 2:
Practice Address - City:FORT PAYNE
Practice Address - State:AL
Practice Address - Zip Code:35967-1625
Practice Address - Country:US
Practice Address - Phone:256-364-8875
Practice Address - Fax:256-364-8875
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-27
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty