Mtn Lake Urology Pc

LBN: Mtn Lake Urology Pc
Mtn Lake Urology Pc is an health care organization with primary practice located at 750 Byron Rd , Scottsboro AL 35769-4051. The organization recently has only one registered license in Other Service Providers / Specialist, which is considered as the primary health care specialty. Mtn Lake Urology Pc can be contacted via phone (256) 259-8765, or through Gross, Sherry via phone (256) 259-8765.

Contact Information

Primary practice address
750 Byron Rd Scottsboro AL 35769-4051
Phone: (256) 259-8765
Fax: (256) 716-8060
Website:
Map and Directions
Authorized official contact:
Name: Gross, Sherry
Phone: (256) 259-8765

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 17993 Alabama

Profile Details

NPI number 1801050364
LBN Legal business name Mtn Lake Urology Pc
DBA Doing business as
Authorized official Gross, Sherry
Entity Organization
Organization subpart 1 No
Enumeration date Jul 14th, 2008
Last updated Mar 21st, 2018 - about 8 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 1801050364 NPPES
Alabama MEDICAID 106277

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