Provider Demographics
NPI:1225006679
Name:FRANKLIN PRIMARY HEALTH CENTER, INC
Entity Type:Organization
Organization Name:FRANKLIN PRIMARY HEALTH CENTER, INC
Other - Org Name:MAYSVILLE MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
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 1:1956 DUVAL ST
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36606
Practice Address - Country:US
Practice Address - Phone:251-471-3747
Practice Address - Fax:251-450-1445
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRANKLIN PRIMARY HEALTH CENTER, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-03-10
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL630003014Medicaid
ALQ727OtherBC/BS
AL011841Medicare Oscar/Certification
AL630003014Medicaid