Provider Demographics
NPI:1699472167
Name:WEST LIMESTONE COMMUNITY CARE
Entity type:Organization
Organization Name:WEST LIMESTONE COMMUNITY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SEBRINA
Authorized Official - Middle Name:B
Authorized Official - Last Name:HOLT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-216-9648
Mailing Address - Street 1:28730 AL 99
Mailing Address - Street 2:STE A
Mailing Address - City:ELKMONT
Mailing Address - State:AL
Mailing Address - Zip Code:35620
Mailing Address - Country:US
Mailing Address - Phone:256-262-6449
Mailing Address - Fax:256-262-6719
Practice Address - Street 1:28730 AL 99
Practice Address - Street 2:STE A
Practice Address - City:ELKMONT
Practice Address - State:AL
Practice Address - Zip Code:35620
Practice Address - Country:US
Practice Address - Phone:256-262-6449
Practice Address - Fax:256-262-6719
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-14
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty