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Contact Information

RENEW FAMILY DERMATOLOGY LLC
212 AIRPORT ROAD W
FORT PAYNE, AL35968
 Phone: 256-979-1250
 Fax: 256-979-1251
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dermatology

207N00000X 07 Physician/Dermatology
 

Medical Specialty

261QM2500X
Indicates primary specialty

NPI Profile & details for RENEW FAMILY DERMATOLOGY LLC

NPI Number 1275198913
LBN Legal business name RENEW FAMILY DERMATOLOGY LLC
Authorized official PAM MASON - (MANAGER)
Entity Organization
Organization subpart 1 No
Enumeration date 05/08/2019
Last updated 03/05/2026 - About 3 months ago
Identifiers
AL Medicaid 236456
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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