Provider Demographics
NPI:1447229208
Name:FRANKLIN PRIMARY HEALTH CENTER, INC.
Entity Type:Organization
Organization Name:FRANKLIN PRIMARY HEALTH CENTER, INC.
Other - Org Name:LOXLEY FAMILY 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:251-434-8177
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:251-434-8177
Mailing Address - Fax:251-436-7765
Practice Address - Street 1:1083 EAST RELHAM DR
Practice Address - Street 2:
Practice Address - City:LOXLEY
Practice Address - State:AL
Practice Address - Zip Code:36551
Practice Address - Country:US
Practice Address - Phone:251-964-4011
Practice Address - Fax:251-436-7765
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRANKLIN PRIMARY HEALTH CENTER, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-03-15
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL630006014Medicaid