Provider Demographics
NPI:1124405022
Name:SNC HOLDING COMPANY LLC
Entity Type:Organization
Organization Name:SNC HOLDING COMPANY LLC
Other - Org Name:CITRA FAMILY HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:FREDERICK
Authorized Official - Middle Name:C
Authorized Official - Last Name:SPOGEN
Authorized Official - Suffix:III
Authorized Official - Credentials:RPHCP
Authorized Official - Phone:352-572-0666
Mailing Address - Street 1:17805 N US HIGHWAY 301
Mailing Address - Street 2:
Mailing Address - City:CITRA
Mailing Address - State:FL
Mailing Address - Zip Code:32113-2459
Mailing Address - Country:US
Mailing Address - Phone:352-595-7777
Mailing Address - Fax:352-595-4047
Practice Address - Street 1:17805 N US HIGHWAY 301
Practice Address - Street 2:
Practice Address - City:CITRA
Practice Address - State:FL
Practice Address - Zip Code:32113-2459
Practice Address - Country:US
Practice Address - Phone:352-595-7777
Practice Address - Fax:352-595-4047
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-29
Last Update Date:2015-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health