MEDICARE: AMERICAN FAMILY CARE, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number State
1	208D00000X	General Practice Physician	AL
2	261Q00000X	Clinic/Center
3	261QU0200X	Urgent Care Clinic/Center
4	261QP2300X	Primary Care Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1346608825
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMERICAN FAMILY CARE, LLC

Provider Business Mailing Address
First Line	:	3700 CAHABA BEACH RD
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35242-5225
Country	:	US
Telephone Number	:	205-403-8902
Fax Number	:	205-421-2109

Provider Business Practice Location Address
First Line	:	101 PAUL STABLER DRIVE
Second Line	:
City	:	GREENVILLE
State	:	AL
Zip	:	36037-0000
Country	:	US
Telephone Number	:	334-382-0734
Fax Number	:	334-382-0795

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. RANDY JOHANSEN
Credential	:
Telephone Number	:	205-421-2101

Provider Enumeration Date	:	01/29/2016
Last Update Date	:	03/27/2025

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Directions to “AMERICAN FAMILY CARE, LLC ” Practice Location

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