Provider Demographics
NPI:1831736339
Name:AFFORDABLE CARE OF ONEONTA
Entity type:Organization
Organization Name:AFFORDABLE CARE OF ONEONTA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:DIODATO
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:205-915-6057
Mailing Address - Street 1:908 2ND AVE E
Mailing Address - Street 2:
Mailing Address - City:ONEONTA
Mailing Address - State:AL
Mailing Address - Zip Code:35121-2506
Mailing Address - Country:US
Mailing Address - Phone:205-625-8389
Mailing Address - Fax:205-273-8189
Practice Address - Street 1:908 2ND AVE E
Practice Address - Street 2:
Practice Address - City:ONEONTA
Practice Address - State:AL
Practice Address - Zip Code:35121-2506
Practice Address - Country:US
Practice Address - Phone:205-625-8389
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-03
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care