Provider Demographics
NPI:1609694348
Name:USA HEALTH COMMUNITY PROVIDERS LLC
Entity type:Organization
Organization Name:USA HEALTH COMMUNITY PROVIDERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:BENNY
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:STOVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-445-9164
Mailing Address - Street 1:PO BOX 36258
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-1204
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5297 ST. IGNATUIS DR
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608
Practice Address - Country:US
Practice Address - Phone:251-434-3475
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-01
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports MedicineGroup - Multi-Specialty