Provider Demographics
NPI:1619429248
Name:FRANKLIN PRIMARY HEALTH CENTER, INC
Entity Type:Organization
Organization Name:FRANKLIN PRIMARY HEALTH CENTER, INC
Other - Org Name:SOUTH MOBILE FAMILY DENTAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:N/A
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-432-4117
Mailing Address - Street 1:1303 DR MARTIN L KING JR AVE
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36603-5341
Mailing Address - Country:US
Mailing Address - Phone:251-432-4117
Mailing Address - Fax:251-436-7765
Practice Address - Street 1:13040 S. WINTZELL AVENUE
Practice Address - Street 2:
Practice Address - City:BAYOU, LA BATRE
Practice Address - State:AL
Practice Address - Zip Code:36509-2110
Practice Address - Country:US
Practice Address - Phone:251-432-4117
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:2016-10-31
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
No122300000XDental ProvidersDentistGroup - Single Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
No1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty
No124Q00000XDental ProvidersDental HygienistGroup - Single Specialty
No126800000XDental ProvidersDental AssistantGroup - Single Specialty