Provider Demographics
NPI:1871832642
Name:FLORENCE FAMILY PRACTICE
Entity Type:Organization
Organization Name:FLORENCE FAMILY PRACTICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:A
Authorized Official - Last Name:BARNES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-404-8968
Mailing Address - Street 1:122 E TENNESSEE ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35630-5655
Mailing Address - Country:US
Mailing Address - Phone:256-764-9830
Mailing Address - Fax:256-764-9832
Practice Address - Street 1:122 E TENNESSEE ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35630-5655
Practice Address - Country:US
Practice Address - Phone:256-764-9830
Practice Address - Fax:256-764-9832
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-13
Last Update Date:2013-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1902852387OtherCIGNA
631053058008OtherTRICARE
AL106524Medicaid
51595427OtherBCBS OF ALABAMA
AL4496846OtherAETNA
AL106524Medicaid