Provider Demographics
NPI:1245591577
Name:RCHP FLORENCE LLC
Entity type:Organization
Organization Name:RCHP FLORENCE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:L
Authorized Official - Last Name:PAGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-844-9849
Mailing Address - Street 1:PO BOX 10005
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35631-2005
Mailing Address - Country:US
Mailing Address - Phone:256-768-9191
Mailing Address - Fax:
Practice Address - Street 1:541 W COLLEGE ST
Practice Address - Street 2:3100
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35630-5323
Practice Address - Country:US
Practice Address - Phone:256-768-9191
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-04
Last Update Date:2014-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL102G706051Medicare PIN