Healthcare Provider Details

I. General information

NPI: 1356897524
Provider Name (Legal Business Name): TAYLORALAN HEALTHCARE,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2016
Last Update Date: 09/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

118 SHORE FRONT LN
WILSONVILLE AL
35186-8613
US

IV. Provider business mailing address

118 SHORE FRONT LN
WILSONVILLE AL
35186-8613
US

V. Phone/Fax

Practice location:
  • Phone: 205-516-0037
  • Fax:
Mailing address:
  • Phone: 205-516-0037
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. TAYLOR ALAN PHARR
Title or Position: MANAGER
Credential:
Phone: 205-516-0037