Provider Demographics
NPI:1710923198
Name:FAMILY & INDUSTRIAL HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:FAMILY & INDUSTRIAL HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NORMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GARRISON
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:334-281-3665
Mailing Address - Street 1:PO BOX 241487
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36124-1487
Mailing Address - Country:US
Mailing Address - Phone:334-281-3665
Mailing Address - Fax:334-281-3578
Practice Address - Street 1:4725 MOBILE HWY
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36108-5126
Practice Address - Country:US
Practice Address - Phone:334-281-3665
Practice Address - Fax:334-281-3578
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL13665261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL=========OtherFEDERAL TAX ID#