Provider Demographics
NPI:1376879064
Name:HEALTH FIRST FAMILY CARE, PC
Entity Type:Organization
Organization Name:HEALTH FIRST FAMILY CARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DUPE
Authorized Official - Middle Name:
Authorized Official - Last Name:MORAFA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-722-0088
Mailing Address - Street 1:PO BOX 42116
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38174-2116
Mailing Address - Country:US
Mailing Address - Phone:901-722-0088
Mailing Address - Fax:901-722-0082
Practice Address - Street 1:2693 UNION AVENUE EXT
Practice Address - Street 2:SUITE 100
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38112-4403
Practice Address - Country:US
Practice Address - Phone:901-722-0088
Practice Address - Fax:901-722-0082
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-30
Last Update Date:2015-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1518537Medicaid
103G701466Medicare PIN