Healthcare Provider Details
I. General information
NPI: 1174453203
Provider Name (Legal Business Name): PRICE FAMILY CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
314 MAIN ST
WATERLOO AL
35677-4401
US
IV. Provider business mailing address
1460 COUNTY ROAD 60
FLORENCE AL
35633-1830
US
V. Phone/Fax
- Phone: 256-629-0033
- Fax: 256-629-0042
- Phone: 256-629-0033
- Fax: 256-629-0042
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2300X |
| Taxonomy | Primary Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
AMANDA
PRICE
Title or Position: CRNP
Credential: CRNP
Phone: 256-762-8683