FAYETTE MEDICAL CENTER
Adult Care Home
Fayette, Alabama
Provider NPI: 1245226430
Organization Information:Organization Name: FAYETTE MEDICAL CENTER
Practice Location:
1653 TEMPLE AVE N FAYETTE, AL 35555 US
Tel: 205-343-8500 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
1653 TEMPLE AVE N FAYETTE, AL 35555 US
Tel: 205-343-8500 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 311ZA0620X | Nursing & Custodial Care Facilities Custodial Care Facility Adult Care Home | AL | 12539 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
BLUE CROSS | 010124 | AL | 01 |
4753120S | AL | 05 | |
RAILROAD MEDICARE | CG6924 | AL | 01 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin