Lakeshore Pediatrics Pc

LBN: Lakeshore Pediatrics Pc
Lakeshore Pediatrics Pc is an health care organization with primary practice located at 12521 Al Highway 157 Ste B , Moulton AL 35650-1937. The organization recently has only one registered license in Ambulatory Health Care Facilities / Rural Health, which is considered as the primary health care specialty. Lakeshore Pediatrics Pc can be contacted via phone (256) 974-6300, or through Rivas, Agustin via phone (256) 386-4151.

Contact Information

Primary practice address
12521 Al Highway 157 Ste B Moulton AL 35650-1937
Phone: (256) 974-6300
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Rivas, Agustin Doctor of Medicine (MD)
Phone: (256) 386-4151

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Rural Health 261QR1300X 17108 Alabama

Profile Details

NPI number 1801238787
LBN Legal business name Lakeshore Pediatrics Pc
DBA Doing business as
Authorized official Rivas, Agustin Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jul 22nd, 2013
Last updated Jul 22nd, 2013 - about 11 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1801238787 NPPES
Alabama MEDICAID 1588002455

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