Provider Demographics
NPI:1659826253
Name:HANCEVILLE ACUTE CARE AND WELLNESS CENTER, LLC
Entity type:Organization
Organization Name:HANCEVILLE ACUTE CARE AND WELLNESS CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:BROCK
Authorized Official - Last Name:CAMP
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:256-352-8884
Mailing Address - Street 1:307 MAIN ST SW
Mailing Address - Street 2:SUITE A
Mailing Address - City:HANCEVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35077-5476
Mailing Address - Country:US
Mailing Address - Phone:256-352-8884
Mailing Address - Fax:256-352-8887
Practice Address - Street 1:307 MAIN ST SW
Practice Address - Street 2:SUITE A
Practice Address - City:HANCEVILLE
Practice Address - State:AL
Practice Address - Zip Code:35077-5476
Practice Address - Country:US
Practice Address - Phone:256-352-8884
Practice Address - Fax:256-352-8887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-24
Last Update Date:2016-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD.32514261QU0200X
261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care