Provider Demographics
NPI:1104364892
Name:FAMILY PRIVATE CARE ALABAMA, LLC
Entity Type:Organization
Organization Name:FAMILY PRIVATE CARE ALABAMA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TONY
Authorized Official - Middle Name:
Authorized Official - Last Name:PLUMMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-620-3064
Mailing Address - Street 1:1905 WOODSTOCK RD
Mailing Address - Street 2:SUITE 5200
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075-5616
Mailing Address - Country:US
Mailing Address - Phone:678-620-3064
Mailing Address - Fax:
Practice Address - Street 1:402 OFFICE PARK DR
Practice Address - Street 2:SUITE 240
Practice Address - City:MOUNTAIN BRK
Practice Address - State:AL
Practice Address - Zip Code:35223-2417
Practice Address - Country:US
Practice Address - Phone:205-870-8855
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-02
Last Update Date:2017-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care