Greater Alabama Family Foot Care Inc
Organization Active NPI Podiatric Clinic/Center · Lanett, AL
NPI 1295940260 · NPPES record last updated Mar 1, 2013
Key facts
- NPI
- 1295940260
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Podiatric Clinic/Center 261QP1100X
- License
- 193 (AL)
- Legal business name
- GREATER ALABAMA FAMILY FOOT CARE INC
- Practice address
- 26 Veterans Memorial Pkwy
Lanett, AL 36863-2840 - Phone
- (334) 642-3668
- Fax
- (334) 642-3669
- NPI assigned
- May 13, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Rona Renell Green, DPM
- Title
- Ceo
- Phone
- (334) 642-3668
Practitioners 1
-
Rona Renell Green, DPM
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040510000357 | AL | Part B Supplier - Clinic/Group Practice | 5799774394 |
Receives reassigned benefits from 1 practitioner Practice locations: Lanett, AL; Roanoke, AL |
National Provider Directory
Locations
26 Veterans Memorial Pkwy
Lanett, AL 36863
Phone (334) 642-3668
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatric Clinic/Center | 261QP1100X | 193 | AL | Yes |
Addresses
Primary practice location
26 Veterans Memorial Pkwy
Lanett, AL 36863-2840
Mailing address
PO Box 1026
Lanett, AL 36863-1026
Phone (334) 642-3668
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 193 | Other | AL | AL STATE LIC. NUMBER |
| 51510661 | Other | AL | AL BCBS NUMBER |
Other providers in Lanett, AL
- Collins Family Dentistry
- Erin Alezandria Darden
- Diversicare of Lanett, LLC
- Sherylene Elizabeth Edmonson
- James William Elliott
- Steven Alexander Hale
- Hand in Hand Connections Group LLC
- Anne Marie Hardy-Fannings
- Marry Ann He
- Cheryl Deneen Hill
All providers in Lanett, AL · Podiatric Clinic/Center in Alabama
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 1, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.