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General NPI Number Information
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NPI Number | 1316953714
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Entity Type | Organization
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Legal Business Name | AMERICAN FAMILY CARE, LLC
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Dates
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Enumeration Date | 07/31/2006
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Last Update Date | 03/27/2025
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Provider Practice Location Address
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Address Line | 6631 PARK DR
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City | DAPHNE
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State | AL
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Zip | 36526-5227
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Country | US
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Telephone | 251-626-5700
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Fax | 251-626-5705
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Provider Business Mailing Address
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Address Line | 2147 RIVERCHASE OFFICE RD
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City | BIRMINGHAM
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State | AL
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Zip | 35244
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Country | US
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Telephone | 205-403-8902
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Fax | 205-982-0278
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. RANDY A JOHANSEN
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Credential |
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Telephone | 205-421-2102
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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