SOUTH ALABAMA MEDICAL CLINIC LLC – NPI #1386912723
Clinic/Center

SOUTH ALABAMA MEDICAL CLINIC LLC is an AHC clinic located in GRAND BAY, AL. NPPES has assigned the NPI number 1386912723 to SOUTH ALABAMA MEDICAL CLINIC LLC on December 13, 2011. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 261QR1300X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Rural Health Keep in mind, having a taxonomy code selected doesn't replace any credentialing or validation process that may be required by law.

The NPI profile was last updated on Jul 23, 2024. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for SOUTH ALABAMA MEDICAL CLINIC LLC below.

NPI Profile for
SOUTH ALABAMA MEDICAL CLINIC LLC

NPI Number
1386912723
Enumeration Date

(more than 14 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
SOUTH ALABAMA MEDICAL CLINIC LLC
Primary location
10075 GRAND BAY WILMER RD S
GRAND BAY, AL 36541-5003
Phone: (251) 865-1852 Fax: (251) 865-1854
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
BRIDGOT PETERS
DIRECTOR
Phone: (251) 865-1852
Updated
Certification Date
Jul 23, 2024

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QR1300X
- Clinic/Center / Rural Health (Primary)
208000000X
- Pediatrics
207R00000X
- Internal Medicine
207Q00000X
- Family Medicine
101YP2500X
- Counselor / Professional
101Y00000X
- Counselor

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.