Provider Demographics
NPI:1174541023
Name:ATTENTUS TROY, LLC
Entity type:Organization
Organization Name:ATTENTUS TROY, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CHIEF MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:D
Authorized Official - Last Name:GORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-372-7000
Mailing Address - Street 1:1340 HIGHWAY 231 S
Mailing Address - Street 2:SUITE 8
Mailing Address - City:TROY
Mailing Address - State:AL
Mailing Address - Zip Code:36081-3011
Mailing Address - Country:US
Mailing Address - Phone:334-670-6646
Mailing Address - Fax:334-670-0076
Practice Address - Street 1:1340 HIGHWAY 231 S
Practice Address - Street 2:SUITE 8
Practice Address - City:TROY
Practice Address - State:AL
Practice Address - Zip Code:36081-3011
Practice Address - Country:US
Practice Address - Phone:334-670-6646
Practice Address - Fax:334-670-0076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NOT REQUIRED IN AL261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
K539Medicare ID - Type Unspecified