Provider Demographics
NPI:1144568999
Name:LITTLE FLOWER FAMILY MEDICINE, LLC
Entity Type:Organization
Organization Name:LITTLE FLOWER FAMILY MEDICINE, LLC
Other - Org Name:LITTLE FLOWER FAMILY MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAWEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:636-875-1140
Mailing Address - Street 1:207 E PITMAN ST
Mailing Address - Street 2:
Mailing Address - City:O FALLON
Mailing Address - State:MO
Mailing Address - Zip Code:63366-2620
Mailing Address - Country:US
Mailing Address - Phone:636-875-1140
Mailing Address - Fax:636-875-1960
Practice Address - Street 1:207 E PITMAN ST
Practice Address - Street 2:
Practice Address - City:O FALLON
Practice Address - State:MO
Practice Address - Zip Code:63366-2620
Practice Address - Country:US
Practice Address - Phone:636-875-1140
Practice Address - Fax:636-898-1960
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-29
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty