Wetumpka Family Rural Health Clinic

LBN: Ivy Creek Of Elmore Llc
Wetumpka Family Rural Health Clinic is an health care organization with primary practice located at 815 Jackson Trace Rd , Wetumpka AL 36092-1504. The organization recently has only one registered license in Ambulatory Health Care Facilities / Rural Health, which is considered as the primary health care specialty. Ivy Creek Of Elmore Llc can be contacted via phone (334) 567-2882, or through Bruce, Michael D via phone (334) 567-4311.

Contact Information

Primary practice address
815 Jackson Trace Rd Wetumpka AL 36092-1504
Phone: (334) 567-2882
Fax: (334) 567-3361
Website:
Map and Directions
Authorized official contact:
Name: Bruce, Michael D
Phone: (334) 567-4311

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Rural Health 261QR1300X

Profile Details

NPI number 1316246812
LBN Legal business name Ivy Creek Of Elmore Llc
DBA Doing business as Wetumpka Family Rural Health Clinic
Authorized official Bruce, Michael D
Entity Organization
Organization subpart 1 No
Enumeration date Mar 23rd, 2011
Last updated Apr 5th, 2022 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1316246812 NPPES
Alabama MEDICAID 540003434
Alabama Other 013434
Alabama Other 01D0891738
Alabama Other 102G701614

Popular Providers