Provider Demographics
NPI:1407939424
Name:RAINBOW FAMILY MEDICAL CLINIC, PC
Entity Type:Organization
Organization Name:RAINBOW FAMILY MEDICAL CLINIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LOUIE
Authorized Official - Middle Name:FRANKLIN
Authorized Official - Last Name:HOOD
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:256-442-0740
Mailing Address - Street 1:3747 HOOD DR
Mailing Address - Street 2:
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35907-7072
Mailing Address - Country:US
Mailing Address - Phone:256-442-0740
Mailing Address - Fax:256-442-0740
Practice Address - Street 1:821 RAINBOW DR
Practice Address - Street 2:
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35901-5307
Practice Address - Country:US
Practice Address - Phone:256-442-0740
Practice Address - Fax:256-442-0740
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALL032Medicare ID - Type UnspecifiedGROUP NUMBER
ALE45578Medicare UPIN