| James O. Ellis Health Center | |
|
3532 Greensboro Ave Tuscaloosa AL 35401-7002 | |
| (205) 349-3250 | |
| (205) 345-3993 |
| Full Name | James O. Ellis Health Center |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 3532 Greensboro Ave, Tuscaloosa, Alabama |
| Authorized Official Name and Position | David E Gay (CEO) |
| Authorized Official Contact | 2057586647 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| James O. Ellis Health Center Po Box 2400 Tuscaloosa AL 35403-2400 Ph: (205) 758-6647 | James O. Ellis Health Center 3532 Greensboro Ave Tuscaloosa AL 35401-7002 Ph: (205) 349-3250 |
| NPI Number | 1063606358 |
|---|---|
| Provider Enumeration Date | 08/30/2007 |
| Last Update Date | 05/17/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063606358 | NPI | - | NPPES |
| 630010005 | Medicaid | AL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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