Healthcare Provider Details

I. General information

NPI: 1770921280
Provider Name (Legal Business Name): BFM ENTERPRISES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2013
Last Update Date: 04/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2775 HWY 43
WINFIELD AL
35594-5263
US

IV. Provider business mailing address

2775 HWY 43
WINFIELD AL
35594-5263
US

V. Phone/Fax

Practice location:
  • Phone: 205-487-2066
  • Fax: 205-487-0383
Mailing address:
  • Phone: 205-487-2066
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number31218
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number31218
License Number StateAL

VIII. Authorized Official

Name: KARI ANN BALLARD
Title or Position: RN/OFFICE MANAGER
Credential:
Phone: 205-487-2066