Provider Demographics
NPI:1285792044
Name:TOTAL FAMILY HEALTH CARE CENTER, LLC
Entity type:Organization
Organization Name:TOTAL FAMILY HEALTH CARE CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-844-2943
Mailing Address - Street 1:2804 GREENHILL BLVD NW
Mailing Address - Street 2:SUITE 101
Mailing Address - City:FORT PAYNE
Mailing Address - State:AL
Mailing Address - Zip Code:35968-3029
Mailing Address - Country:US
Mailing Address - Phone:256-844-2943
Mailing Address - Fax:256-844-2939
Practice Address - Street 1:2804 GREENHILL BLVD NW
Practice Address - Street 2:SUITE 101
Practice Address - City:FORT PAYNE
Practice Address - State:AL
Practice Address - Zip Code:35968-3029
Practice Address - Country:US
Practice Address - Phone:256-844-2943
Practice Address - Fax:256-844-2939
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALD0704207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51001927OtherBLUE CROSS BLUE SHIELD
ALD60634Medicare UPIN