Healthcare Provider Details

I. General information

NPI: 1982910089
Provider Name (Legal Business Name): AMERICAN FAMILY CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2010
Last Update Date: 03/27/2025
Certification Date: 03/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2604 HIGHWAY 31 S
DECATUR AL
35603-1506
US

IV. Provider business mailing address

3700 CAHABA BEACH RD
BIRMINGHAM AL
35242-5225
US

V. Phone/Fax

Practice location:
  • Phone: 256-445-3050
  • Fax: 256-445-3053
Mailing address:
  • Phone: 205-403-8902
  • Fax: 205-421-2109

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. RANDY JOHANSEN
Title or Position: PRESIDENT
Credential:
Phone: 205-421-2102