Provider Demographics
NPI:1154725265
Name:G & G MEDICAL CARE INC.
Entity type:Organization
Organization Name:G & G MEDICAL CARE INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:A
Authorized Official - Last Name:STANFORD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-685-4870
Mailing Address - Street 1:225 HELENA MARKET PL
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:AL
Mailing Address - Zip Code:35080-3395
Mailing Address - Country:US
Mailing Address - Phone:205-685-4870
Mailing Address - Fax:205-685-4869
Practice Address - Street 1:5152 COLONIAL PARK RD
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35242-3264
Practice Address - Country:US
Practice Address - Phone:205-685-4870
Practice Address - Fax:205-685-4869
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-17
Last Update Date:2015-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL102G705775OtherMEDICARE GROUP PTAN
AL01D2085824OtherCLIA