Provider Type Icon

OLYMPUS DIRECT PRIMARY CARE. P.C. NPI 1619696598


NPI Information

NPI: 1619696598
Provider Name: OLYMPUS DIRECT PRIMARY CARE. P.C.
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 01D2267067

Address:
1311 DECATUR HWY STE C
FULTONDALE, AL
ZIP 35068
Phone: (205) 927-5185
Get Directions

OLYMPUS DIRECT PRIMARY CARE. P.C. is a family medicine in Fultondale, AL. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. OLYMPUS DIRECT PRIMARY CARE. P.C. NPI is 1619696598. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1311 DECATUR HWY STE C
FULTONDALE, AL
ZIP 35068-737
Phone: (205) 927-5185

The provider's authorized official is Justin Thomas Cooke .
The authorized official title is Owner/president and has the following contact phone number (484) 788-4788.

The CLIA number assigned to this NPI record is 01D2267067 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/24/2022 and was last updated on 8/24/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.