Provider Demographics
NPI:1740614072
Name:UNITED FLORALA INC.
Entity type:Organization
Organization Name:UNITED FLORALA INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DOREEN
Authorized Official - Middle Name:
Authorized Official - Last Name:BOCK
Authorized Official - Suffix:
Authorized Official - Credentials:COO
Authorized Official - Phone:334-858-3287
Mailing Address - Street 1:24245 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:FLORALA
Mailing Address - State:AL
Mailing Address - Zip Code:36442-3523
Mailing Address - Country:US
Mailing Address - Phone:334-858-2282
Mailing Address - Fax:334-858-2283
Practice Address - Street 1:24245 5TH AVE
Practice Address - Street 2:
Practice Address - City:FLORALA
Practice Address - State:AL
Practice Address - Zip Code:36442-3523
Practice Address - Country:US
Practice Address - Phone:334-858-2282
Practice Address - Fax:334-858-2283
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FLORALA MEMORIAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-08-22
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health