Provider Demographics
NPI:1578331914
Name:FAMILY FIRST PRIMARY CARE, LLC
Entity Type:Organization
Organization Name:FAMILY FIRST PRIMARY CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:LYDIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GODSEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-712-5110
Mailing Address - Street 1:105 JW PLAZA DR SE STE 6
Mailing Address - Street 2:
Mailing Address - City:CALHOUN
Mailing Address - State:GA
Mailing Address - Zip Code:30701-1503
Mailing Address - Country:US
Mailing Address - Phone:205-712-5110
Mailing Address - Fax:
Practice Address - Street 1:105 JW PLAZA DR SE STE 6
Practice Address - Street 2:
Practice Address - City:CALHOUN
Practice Address - State:GA
Practice Address - Zip Code:30701-1503
Practice Address - Country:US
Practice Address - Phone:205-712-5110
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-14
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty