Provider Demographics
NPI:1508106592
Name:IMMEDIATE CARE FOLEY LLC
Entity Type:Organization
Organization Name:IMMEDIATE CARE FOLEY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:PORTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-300-2785
Mailing Address - Street 1:PO BOX 91747
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36691-1747
Mailing Address - Country:US
Mailing Address - Phone:251-300-2785
Mailing Address - Fax:251-300-2771
Practice Address - Street 1:1265 S MCKENZIE ST
Practice Address - Street 2:
Practice Address - City:FOLEY
Practice Address - State:AL
Practice Address - Zip Code:36535-1818
Practice Address - Country:US
Practice Address - Phone:251-300-2785
Practice Address - Fax:251-300-2771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-27
Last Update Date:2013-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty