| NPI | 1679532303 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES WHITE CEO 251-434-8177 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 122300000X Dentist |
| 133N00000X Nutritionist | |
| 152W00000X Optometrist | |
| 183500000X Pharmacist | |
| 207Q00000X Family Medicine | |
| 207R00000X Internal Medicine | |
| 207V00000X Obstetrics & Gynecology | |
| 208000000X Pediatrics | |
| 2085B0100X Radiology, Body Imaging | |
| 208M00000X Hospitalist | |
| 291U00000X Clinical Medical Laboratory | |
| 333600000X Pharmacy | |
| 3336C0002X Pharmacy, Clinic Pharmacy | |
| Enumeration Date | 2006-03-21 |
| Last Update Date | 2022-08-23 |