Provider Demographics
NPI:1467075275
Name:FLORALA FAMILY CARE LLC
Entity Type:Organization
Organization Name:FLORALA FAMILY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SASSER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-684-9208
Mailing Address - Street 1:PO BOX 328
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:AL
Mailing Address - Zip Code:36340-0328
Mailing Address - Country:US
Mailing Address - Phone:334-684-9208
Mailing Address - Fax:
Practice Address - Street 1:24245 5TH AVE
Practice Address - Street 2:
Practice Address - City:FLORALA
Practice Address - State:AL
Practice Address - Zip Code:36442-3523
Practice Address - Country:US
Practice Address - Phone:334-684-9208
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-27
Last Update Date:2020-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care