NPI Code Details Logo

NPI 1255137212

NPI 1255137212 : ADVANTAGE FAMILY CARE INC : HOOVER, AL

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1255137212
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    ADVANTAGE FAMILY CARE INC 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    02/20/2025
-----------------------------------------------------
    Last Update Date     |    02/21/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    1539 MONTGOMERY HWY STE 101 
-----------------------------------------------------
    City                 |    HOOVER
-----------------------------------------------------
    State                |    AL
-----------------------------------------------------
    Zip                  |    35216-4557
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    659-599-9513
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    30 BURTON HILLS BLVD STE 175 
-----------------------------------------------------
    City                 |    NASHVILLE
-----------------------------------------------------
    State                |    TN
-----------------------------------------------------
    Zip                  |    37215-6403
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    615-988-2000
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    CREDENTIALING MANAGER
-----------------------------------------------------
    Name                 |     CRYSTAL D GIBSON 
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    615-988-2009
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    261Q00000X
-----------------------------------------------------
    Taxonomy Name        |    Clinic/Center
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
    Taxonomy Code        |    261QU0200X
-----------------------------------------------------
    Taxonomy Name        |    Urgent Care Clinic/Center
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
    Taxonomy Code        |    207Q00000X
-----------------------------------------------------
    Taxonomy Name        |    Family Medicine Physician
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2025 Data Labs Health. All rights reserved.