Provider Demographics
NPI:1598316895
Name:FLORENCE HEALTH COMPLEX, LLC
Entity Type:Organization
Organization Name:FLORENCE HEALTH COMPLEX, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:CRAIG
Authorized Official - Last Name:SILLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-278-5831
Mailing Address - Street 1:130 S CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:MS
Mailing Address - Zip Code:39073-8478
Mailing Address - Country:US
Mailing Address - Phone:601-891-8134
Mailing Address - Fax:
Practice Address - Street 1:130 S CHURCH ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:MS
Practice Address - Zip Code:39073-8478
Practice Address - Country:US
Practice Address - Phone:601-891-8134
Practice Address - Fax:601-891-8364
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-27
Last Update Date:2019-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center