Provider Demographics
| NPI: | 1043794480 |
|---|---|
| Name: | FRANKLIN PRIMARY HEALTH CENTER, INC. |
| Entity Type: | Organization |
| Organization Name: | FRANKLIN PRIMARY HEALTH CENTER, INC. |
| Other - Org Name: | FRANKLIN'S WELLNESS, SMILES & VISION EXPRESS |
| Other - Org Type: | Doing Business As |
| Authorized Official - Title/Position: | CEO |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | CHARLES |
| Authorized Official - Middle Name: | N/A |
| Authorized Official - Last Name: | WHITE |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 251-432-4117 |
| Mailing Address - Street 1: | PO BOX 2048 |
| Mailing Address - Street 2: | |
| Mailing Address - City: | MOBILE |
| Mailing Address - State: | AL |
| Mailing Address - Zip Code: | 36652-2048 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 251-432-4117 |
| Mailing Address - Fax: | 251-436-7765 |
| Practice Address - Street 1: | 1303 DR MARTIN L KING JR AVE |
| Practice Address - Street 2: | |
| Practice Address - City: | MOBILE |
| Practice Address - State: | AL |
| Practice Address - Zip Code: | 36603-5341 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 251-432-4117 |
| Practice Address - Fax: | 251-436-7765 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | Yes |
| Parent Organization LBN: | FRANKLIN PRIMARY HEALTH CENTER, INC. |
| Parent Organization TIN: | <UNAVAIL> |
| Enumeration Date: | 2018-09-21 |
| Last Update Date: | 2022-08-30 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 261QF0400X | Ambulatory Health Care Facilities | Clinic/Center | Federally Qualified Health Center (FQHC) | Group - Multi-Specialty |
| No | 104100000X | Behavioral Health & Social Service Providers | Social Worker | Group - Multi-Specialty | |
| No | 122300000X | Dental Providers | Dentist | Group - Multi-Specialty | |
| No | 133N00000X | Dietary & Nutritional Service Providers | Nutritionist | Group - Multi-Specialty | |
| No | 152W00000X | Eye and Vision Services Providers | Optometrist | Group - Multi-Specialty | |
| No | 171M00000X | Other Service Providers | Case Manager/Care Coordinator | Group - Multi-Specialty | |
| No | 183500000X | Pharmacy Service Providers | Pharmacist | Group - Multi-Specialty | |
| No | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Multi-Specialty | |
| No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
| No | 207V00000X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Group - Multi-Specialty | |
| No | 207W00000X | Allopathic & Osteopathic Physicians | Ophthalmology | Group - Multi-Specialty | |
| No | 208000000X | Allopathic & Osteopathic Physicians | Pediatrics | Group - Multi-Specialty | |
| No | 2085B0100X | Allopathic & Osteopathic Physicians | Radiology | Body Imaging | Group - Multi-Specialty |
| No | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Group - Multi-Specialty | |
| No | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Group - Multi-Specialty |
