Provider Demographics
NPI:1497724256
Name:FRANKLIN PRIMARY HEALTH CENTER, INC
Entity Type:Organization
Organization Name:FRANKLIN PRIMARY HEALTH CENTER, INC
Other - Org Name:HADLEY 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:251-432-4117
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 1:572 STANTON RD
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36617
Practice Address - Country:US
Practice Address - Phone:251-450-8055
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
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL630009014Medicaid