Provider Demographics
NPI:1790937845
Name:ARAB FAMILY HEALTHCARE LLC
Entity Type:Organization
Organization Name:ARAB FAMILY HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:WADE
Authorized Official - Last Name:HARGRAVES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:256-224-9167
Mailing Address - Street 1:180 GREYSTONE PASS
Mailing Address - Street 2:
Mailing Address - City:GUNTERSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35976-4801
Mailing Address - Country:US
Mailing Address - Phone:256-224-9167
Mailing Address - Fax:256-931-0781
Practice Address - Street 1:180 GREYSTONE PASS
Practice Address - Street 2:
Practice Address - City:GUNTERSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35976-4801
Practice Address - Country:US
Practice Address - Phone:256-224-9167
Practice Address - Fax:256-486-9244
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-21
Last Update Date:2021-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL9277207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1821048794OtherNPI INDIVIDUAL
ALC72330Medicare UPIN