1295080489 NPI number — RCHP-FLORENCE, LLC

Table of content: (NPI 1295080489)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295080489 NPI number — RCHP-FLORENCE, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RCHP-FLORENCE, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1295080489
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/16/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 10005
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FLORENCE
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35631-2005
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
256-768-9191
Provider Business Mailing Address Fax Number:
256-768-9775

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
203 AVALON AVE
Provider Second Line Business Practice Location Address:
SUITE 270
Provider Business Practice Location Address City Name:
MUSCLE SHOALS
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35661-2869
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
256-386-1436
Provider Business Practice Location Address Fax Number:
256-386-1438
Provider Enumeration Date:
07/13/2012

Additional Information

Authorized Official

Authorized Official Last Name:
HOBBS
Authorized Official First Name:
STEPHEN
Authorized Official Middle Name:
E
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
256-768-9191

Provider Taxonomy Codes

  • Taxonomy code: 2083X0100X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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