Provider Demographics
NPI:1215208632
Name:AMBULATORY CARE CLINIC L.L.C
Entity type:Organization
Organization Name:AMBULATORY CARE CLINIC L.L.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER-MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:FLOWER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:340-642-7233
Mailing Address - Street 1:1619 SIXTH ST
Mailing Address - Street 2:
Mailing Address - City:ST THOMAS
Mailing Address - State:VI
Mailing Address - Zip Code:00802-2635
Mailing Address - Country:US
Mailing Address - Phone:340-643-7233
Mailing Address - Fax:
Practice Address - Street 1:1619 SIXTH ST
Practice Address - Street 2:
Practice Address - City:ST THOMAS
Practice Address - State:VI
Practice Address - Zip Code:00802-2635
Practice Address - Country:US
Practice Address - Phone:340-643-7233
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-17
Last Update Date:2012-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VI1-16363-1L261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care