Provider Demographics
NPI:1275899031
Name:THE FAMILY FIRST HEALTH CLINIC AT THE ROCK
Entity Type:Organization
Organization Name:THE FAMILY FIRST HEALTH CLINIC AT THE ROCK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAMMYE
Authorized Official - Middle Name:L
Authorized Official - Last Name:BRADLEY
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:256-523-6288
Mailing Address - Street 1:1955 SAND ROCK AVE
Mailing Address - Street 2:
Mailing Address - City:SANDROCK
Mailing Address - State:AL
Mailing Address - Zip Code:35983-4327
Mailing Address - Country:US
Mailing Address - Phone:256-523-6288
Mailing Address - Fax:256-523-6290
Practice Address - Street 1:1955 SAND ROCK AVE
Practice Address - Street 2:
Practice Address - City:SANDROCK
Practice Address - State:AL
Practice Address - Zip Code:35983-4327
Practice Address - Country:US
Practice Address - Phone:256-523-6288
Practice Address - Fax:256-523-6290
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-05
Last Update Date:2012-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty