RURAL HEALTH MEDICAL PROGRAM, INC (NPI# 1295804391) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295804391 |
| Entity Type | Organization |
| Organization Name | RURAL HEALTH MEDICAL PROGRAM, INC |
| Other Organization Name | PINE APPLE HEALTH CENTER |
| Practice Address |
867 County Road 59 Pine Apple AL 36768-3525 |
| Mailing Address |
P O Box 2213 228 Selma Avenue Selma AL 36702-2213 |
| Practice Telephone | 2517462197 |
| Practice Fax Number | 2517462467 |
| Mailing Telephone | 3348747428 |
| Mailing Fax Number | 3348747435 |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2010-12-21 |
| Authorized Official Name | MS. PATRICIA GIBSON (CEO) |
| Authorized Official Telephone | 3348747428 |
| Is Organization Subpart | Y |
| Parent Organization Name | RURAL HEALTH MEDICAL PROGRAM, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
AL | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | MEDICARE ID - TYPE UNSPECIFIED | 011836 | 01 |
| AL | 630000008 | 05 |
| Other Name | Type Code |
|---|---|
| Pine Apple Health Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457994121 | Rural Health Medical Program, Inc | Family Medicine | 3040 S Alabama Ave, Monroeville, AL 36460-5600 | 2019-10-24 |
| 1104995208 | Rural Health Medical Program, Inc | Clinic/Center | 558 County Road 56, Vredenburgh, AL 36481-0494 | 2006-11-06 |
| 1114006848 | Rural Health Medical Program, Inc | Clinic/Center | 1502 Highway 80 East, Unit A, Demopolis, AL 36732 | 2006-11-03 |
| 1871131854 | Rural Health Medical Program, Inc | Counselor | 101 Park Pl, Selma, AL 36701-6764 | 2019-12-20 |
| 1215471032 | Rural Health Medical Program, Inc | Clinic/Center | 111 Main Street, Thomaston, AL 36783-0276 | 2016-12-13 |
| 1992040950 | Rural Health Medical Program, Inc | Clinic/Center | 228 Selma Ave, Selma, AL 36701-5825 | 2012-12-03 |
| Street Address |
867 COUNTY ROAD 59 |
| City | PINE APPLE |
| State | AL |
| Zip Code | 36768-3525 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164501904 | Jane Kelly | Nurse Practitioner | 867 County Road 59, Pine Apple, AL 36768-3525 | 2006-11-03 |
| 1952951584 | Allison Owens | Nurse Practitioner | 867 County Road 59, Pine Apple, AL 36768-3525 | 2019-09-16 |
| 1831614452 | Jackie Dixon | Family Medicine | 867 County Road 59, Pine Apple, AL 36768-3525 | 2017-08-04 |
| 1619357381 | Marlo Wolff | Registered Nurse | 867 County Road 59, Pine Apple, AL 36768-3525 | 2015-06-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568541720 | Roseanne Cook | Family Medicine | 867 Co. Rd 59, Pineapple, AL 36768 | 2006-11-06 |
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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| 1982172367 | Health Services, Inc | Clinic/Center | 3350 S Court St, Montgomery, AL 36105-1606 | 2018-11-05 |
| 1932627858 | Whatley Health Services, Inc. | Clinic/Center | 417 3rd St Se, Aliceville, AL 35442 | 2017-08-30 |
| 1780123372 | Quality of Life Health Services, Inc | Clinic/Center | 404 9th Ave Sw, Lafayette, AL 36862-2806 | 2017-02-16 |
| 1487104691 | Whatley Health Services Inc | Clinic/Center | 142 School Street, Oakman, AL 35579 | 2016-10-12 |
| 1831568237 | Quality of Life Health Services, Inc | Clinic/Center | 1502 11th Ave, Phenix City, AL 36867-4905 | 2015-09-16 |
| 1477939031 | Whatley Health Services, Inc. | Clinic/Center | 3601 Stillman Blvd, Tuscaloosa, AL 35401-2601 | 2015-08-06 |
| Find all providers with the same taxonomy | ||||
| City | PINE APPLE |
| Zip Code | 36768 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.