Organization Name: | AMERICAN FAMILY CARE, INC. |
NPI Number: | 1841508785 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RANDY JOHANSEN (PRESIDENT) |
Mailing Address: | 1965 Cobbs Ford Rd Prattville |
State: | AL US |
Postal Code: | 360667290 |
Phone Number: | 3343617054 |
Fax Number: | 3343618750 |
NPI Enumeration Date: | 09/14/2010 |
NPI Last Update Date: | 07/05/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |