Healthcare Provider Details
I. General information
NPI: 1225006679
Provider Name (Legal Business Name): FRANKLIN PRIMARY HEALTH CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/10/2006
Last Update Date: 08/24/2022
Certification Date: 08/24/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1956 DUVAL ST
MOBILE AL
36606
US
IV. Provider business mailing address
PO BOX 2048
MOBILE AL
36652-2048
US
V. Phone/Fax
- Phone: 251-471-3747
- Fax: 251-450-1445
- Phone: 251-432-4117
- Fax: 251-436-7765
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM1300X |
| Taxonomy | Multi-Specialty Clinic/Center |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QF0400X |
| Taxonomy | Federally Qualified Health Center (FQHC) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
CHARLES
WHITE
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 251-432-4117