MEDMARK TREATMENT CENTERS-OXFORD (MEDMARK TREATMENT CENTERS OF ALABAMA, INC) NPI 1851761225

Clinic/Center (Methadone) in Oxford, AL

NPI 1851761225 Organization Clinic/Center Methadone CLIA Number 01D2104550 CLIA Certificate of Waiver

About MEDMARK TREATMENT CENTERS-OXFORD (MEDMARK TREATMENT CENTERS OF ALABAMA, INC)

Medmark Treatment Centers-oxford (medmark Treatment Centers Of Alabama, Inc) is a provider established in Oxford, Alabama specializing in clinic/center (methadone) . The NPI number of Medmark Treatment Centers-oxford (medmark Treatment Centers Of Alabama, Inc) is 1851761225 and was assigned on September 2015. The practitioner's primary taxonomy code is 261QM2800X. The provider is registered as an organization and their NPI record was last updated one year ago. The provider's is doing business as Medmark Treatment Centers-oxford. The authorized official of this NPI record is Genco D'andria (Cfo)

The CLIA number of Medmark Treatment Centers-oxford is 01D2104550 registered as a "other" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to Medmark Treatment Centers-oxford to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

NPI

1851761225

Provider NameMEDMARK TREATMENT CENTERS-OXFORD (MEDMARK TREATMENT CENTERS OF ALABAMA, INC)
Provider Location Address118 E CHOCCOLOCCO ST OXFORD, AL 36203
Provider Mailing Address1720 LAKEPOINTE DR STE 117 LEWISVILLE, TX 75057
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?Yes
Other Organization NameMEDMARK TREATMENT CENTERS-OXFORD
Other Name TypeDoing Business As (3)
Enumeration Date09-29-2015
Last Update Date01-12-2021


Primary Taxonomy

Taxonomy Code261QM2800X
ClassificationClinic/Center
TypeAmbulatory Health Care Facilities
SpecializationMethadone
Taxonomy DescriptionAn entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction.

Business Address

MEDMARK TREATMENT CENTERS-OXFORD
118 E CHOCCOLOCCO ST
OXFORD, AL
ZIP 36203
Phone: (256) 831-4601
Fax: (256) 831-4601

Get Directions


Mailing Address

MEDMARK TREATMENT CENTERS-OXFORD
1720 LAKEPOINTE DR STE 117
LEWISVILLE, TX
ZIP 75057
Phone: (214) 379-3300
Fax: (214) 853-9018



Authorized Official

Authorized Official Name GENCO D'ANDRIA
Authorized Official TitleCFO
Authorized Official Phone(214) 379-3300

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for the NPI number 1851761225 is:

CLIA Number01D2104550
Facility TypeOTHER
Certificate TypeCertificate of Waiver

Other Providers at the same location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1720476864MS. TANYA ELIZABETH SADI MS
Individual
Counselor (Addiction (Substance Use Disorder))118 E CHOCCOLOCCO ST
OXFORD, AL 36203
(256) 831-4601
1841815297 KARA MEDFORTH MSW
Individual
Counselor118 E CHOCCOLOCCO ST
OXFORD, AL 36203
(256) 831-4601
1043835481 ANGELA BRAGG ADC
Individual
Counselor (Addiction (Substance Use Disorder))118 E CHOCCOLOCCO ST
OXFORD, AL 36203
(256) 831-4601
1417572868 THOMAS JOHN WALL
Individual
Counselor (Addiction (Substance Use Disorder))118 E CHOCCOLOCCO ST
OXFORD, AL 36203
(256) 831-4601
1538784988MRS. REAGAN SCHRADER GREENWOOD MSW
Individual
Counselor (Addiction (Substance Use Disorder))118 E CHOCCOLOCCO ST
OXFORD, AL 36203
(256) 831-4601
1518582840 SHELIA FAYE SHELTON ADC
Individual
Counselor (Addiction (Substance Use Disorder))118 E CHOCCOLOCCO ST
OXFORD, AL 36203
(256) 831-4601
1972128148 JEFF CLARK
Individual
Counselor (Addiction (Substance Use Disorder))118 E CHOCCOLOCCO ST
OXFORD, AL 36203
(256) 831-4601
1740805803 STACY STARLING
Individual
Counselor (Addiction (Substance Use Disorder))118 E CHOCCOLOCCO ST
OXFORD, AL 36203
(256) 831-4601
1003431164 JOHN KELLY I
Individual
Specialist/Technologist (Athletic Trainer)118 E CHOCCOLOCCO ST
OXFORD, AL 36203
(256) 831-4601
1154946234 KEISHA MALIA HEARD
Individual
Counselor (Addiction (Substance Use Disorder))118 E CHOCCOLOCCO ST
OXFORD, AL 36203
(256) 831-4601
1336764216MRS. KASHA DAVETTE NIX ADC
Individual
Counselor (Addiction (Substance Use Disorder))118 E CHOCCOLOCCO ST
OXFORD, AL 36203
(256) 831-4601
1972128809 KASI L BROWN MS
Individual
Counselor (Addiction (Substance Use Disorder))118 E CHOCCOLOCCO ST
OXFORD, AL 36203
(256) 831-4601
1386269223 DEBORAH YIM ADC
Individual
Counselor (Addiction (Substance Use Disorder))118 E CHOCCOLOCCO ST
OXFORD, AL 36203
(256) 831-4601
1902421936MR. ANTHONY CORNELIUS CHATMON SR.
Individual
Counselor (Addiction (Substance Use Disorder))118 E CHOCCOLOCCO ST
OXFORD, AL 36203
(256) 831-4601
1003904301CALHOUN TREATMENT CENTER, INC.
Organization
Community/Behavioral Health118 E CHOCCOLOCCO ST
OXFORD, AL 36203
(256) 831-4601
1225614423 JAIME TURNER HALL LPN
Individual
Licensed Practical Nurse118 E CHOCCOLOCCO ST
OXFORD, AL 36203
(256) 831-4601
1942886148MRS. ANNETTE FUNNICHELLO BUGGS LPN
Individual
Licensed Practical Nurse118 E CHOCCOLOCCO ST
OXFORD, AL 36203
(256) 831-4601
1750967725MRS. JENNIFER LYNN PIERCE LPN
Individual
Licensed Practical Nurse118 E CHOCCOLOCCO ST
OXFORD, AL 36203
(256) 831-4601
1558947291 COURTNEY BUTTERWORTH LPN
Individual
Licensed Practical Nurse118 E CHOCCOLOCCO ST
OXFORD, AL 36203
(256) 831-4601
1265019442 APRIL DAWN EASTERWOOD I
Individual
Licensed Practical Nurse118 E CHOCCOLOCCO ST
OXFORD, AL 36203
(256) 831-4601

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.