Provider Demographics
NPI:1326103821
Name:ALL FAMILY HEALTHCARE
Entity Type:Organization
Organization Name:ALL FAMILY HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLIDAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-886-3996
Mailing Address - Street 1:PO BOX 103
Mailing Address - Street 2:
Mailing Address - City:AUXIER
Mailing Address - State:KY
Mailing Address - Zip Code:41602-0103
Mailing Address - Country:US
Mailing Address - Phone:606-886-3996
Mailing Address - Fax:606-886-3667
Practice Address - Street 1:156 N LAKE DR
Practice Address - Street 2:
Practice Address - City:PRESTONSBURG
Practice Address - State:KY
Practice Address - Zip Code:41653-1270
Practice Address - Country:US
Practice Address - Phone:606-886-3996
Practice Address - Fax:606-886-3667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-26
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY25775207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYE01402Medicare UPIN