Organization Name: | AMERICAN FAMILY CARE INC |
NPI Number: | 1699781005 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RANDY A JOHANSEN (PRESIDENT) |
Mailing Address: | 2570 Berryhill Rd Montgomery |
State: | AL US |
Postal Code: | 361173564 |
Phone Number: | 3343231330 |
Fax Number: | 3343231327 |
NPI Enumeration Date: | 07/31/2006 |
NPI Last Update Date: | 04/25/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |