Provider Demographics
NPI:1356897524
Name:TAYLORALAN HEALTHCARE,LLC
Entity type:Organization
Organization Name:TAYLORALAN HEALTHCARE,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:TAYLOR
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:PHARR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-516-0037
Mailing Address - Street 1:118 SHORE FRONT LN
Mailing Address - Street 2:
Mailing Address - City:WILSONVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35186-8613
Mailing Address - Country:US
Mailing Address - Phone:205-516-0037
Mailing Address - Fax:
Practice Address - Street 1:118 SHORE FRONT LN
Practice Address - Street 2:
Practice Address - City:WILSONVILLE
Practice Address - State:AL
Practice Address - Zip Code:35186-8613
Practice Address - Country:US
Practice Address - Phone:205-516-0037
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-28
Last Update Date:2016-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care