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General NPI Number Information
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NPI Number | 1952317117
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Entity Type | Organization
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Legal Business Name | FAMILY CARE HOME PA
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Dates
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Enumeration Date | 07/31/2006
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Last Update Date | 10/26/2012
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Provider Practice Location Address
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Address Line | 3164 US HIGHWAY 70
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City | BLACK MOUNTAIN
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State | NC
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Zip | 28711
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Country | US
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Telephone | 828-669-4505
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Fax | 828-669-5112
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Provider Business Mailing Address
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Address Line | 3164 US HIGHWAY 70
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City | BLACK MOUNTAIN
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State | NC
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Zip | 28711
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Country | US
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Telephone | 828-669-4505
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Fax | 828-669-5112
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | MR. ALAN FRANKLIN HUSKINS
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Credential |
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Telephone | 828-669-4505
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 122566
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2012-00350
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License Number State | NC
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