Provider Demographics
NPI:1891908968
Name:AMERICAN FAMILY CARE, LLC
Entity Type:Organization
Organization Name:AMERICAN FAMILY CARE, LLC
Other - Org Name:NEXSTEP - FORESTDALE
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHANSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-421-2101
Mailing Address - Street 1:3700 CAHABA BEACH RD
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-5225
Mailing Address - Country:US
Mailing Address - Phone:205-403-8902
Mailing Address - Fax:205-421-2109
Practice Address - Street 1:1664 FORESTDALE BLVD
Practice Address - Street 2:
Practice Address - City:FORESTDALE
Practice Address - State:AL
Practice Address - Zip Code:35214-2042
Practice Address - Country:US
Practice Address - Phone:205-791-2273
Practice Address - Fax:205-791-9753
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMERICAN FAMILY CARE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-07
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALCA6570OtherRAILROAD MEDICARE
AL529202590Medicaid
AL1201300023Medicare NSC
AL1201300008Medicare NSC
AL1201300009Medicare NSC
ALJ283Medicare ID - Type UnspecifiedGROUP NUMBER
AL1201300025Medicare NSC
AL1201300002Medicare NSC
ALCA6570OtherRAILROAD MEDICARE
AL1201300007Medicare NSC
AL1201300024Medicare NSC
AL1201300005Medicare NSC
AL1201300003Medicare NSC
AL1201300001Medicare NSC
AL1201300020Medicare NSC
AL1201300022Medicare NSC
AL1201300004Medicare NSC
AL1201300011Medicare NSC
AL1201300015Medicare NSC
AL1201300021Medicare NSC
AL1201300014Medicare NSC