Provider Demographics
NPI:1467600916
Name:TMC WOODLAND FAMILY HEALTHCARE, INC.
Entity Type:Organization
Organization Name:TMC WOODLAND FAMILY HEALTHCARE, INC.
Other - Org Name:WOODLAND FAMILY HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:CLINT
Authorized Official - Middle Name:
Authorized Official - Last Name:HOFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-838-8845
Mailing Address - Street 1:100 GREENWAY BLVD FL 2
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:GA
Mailing Address - Zip Code:30117-4338
Mailing Address - Country:US
Mailing Address - Phone:770-838-8710
Mailing Address - Fax:
Practice Address - Street 1:76 COUNTY ROAD 64
Practice Address - Street 2:SUITE 3
Practice Address - City:WOODLAND
Practice Address - State:AL
Practice Address - Zip Code:36280-5209
Practice Address - Country:US
Practice Address - Phone:256-449-2001
Practice Address - Fax:256-449-2174
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-08
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD.9389207Q00000X
261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural HealthGroup - Single Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL105984Medicaid
AL510G700404OtherGROUP PTAN
AL125316Medicaid
AL105984Medicaid