Basic Information
| Provider Information | |||||||||
| NPI: | 1245779529 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | AMERICAN FAMILY CARE, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1965 COBBS FORD RD | ||||||||
| Address2: | |||||||||
| City: | PRATTVILLE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 360667290 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3343617054 | ||||||||
| FaxNumber: | 3343618750 | ||||||||
| Practice Location | |||||||||
| Address1: | 1965 COBBS FORD RD | ||||||||
| Address2: | |||||||||
| City: | PRATTVILLE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 360667290 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3343617054 | ||||||||
| FaxNumber: | 3343618750 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/20/2017 | ||||||||
| LastUpdateDate: | 02/20/2017 | ||||||||
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| AuthorizedOfficialLastName: | VALENTINE | ||||||||
| AuthorizedOfficialFirstName: | SALISIA | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | DIRECTOR OF PHYSICIAN EXTENDERS | ||||||||
| AuthorizedOfficialTelephone: | 2054212088 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | CRNP | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261Q00000X | 1-138779 | AL | Y | Ambulatory Health Care Facilities | Clinic/Center |
No ID Information.