Healthcare Provider Details

I. General information

NPI: 1245591577
Provider Name (Legal Business Name): RCHP FLORENCE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2012
Last Update Date: 09/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

541 W COLLEGE ST 3100
FLORENCE AL
35630-5323
US

IV. Provider business mailing address

PO BOX 10005
FLORENCE AL
35631-2005
US

V. Phone/Fax

Practice location:
  • Phone: 256-768-9191
  • Fax:
Mailing address:
  • Phone: 256-768-9191
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: STEPHEN L. PAGE
Title or Position: VICE PRESIDENT
Credential:
Phone: 615-844-9849