FAMILY HEALTH CARE CLINIC, INC. (NPI# 1831322841) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831322841 |
| Entity Type | Organization |
| Organization Name | FAMILY HEALTH CARE CLINIC, INC. |
| Practice Address |
318 Coffee Ave Ne Russellville AL 35653 |
| Mailing Address |
Po Box 24116 Jackson MS 39225-4116 |
| Practice Telephone | 6018257280 |
| Practice Fax Number | 6018258130 |
| Mailing Telephone | 6018257280 |
| Mailing Fax Number | 6018258130 |
| Enumeration Date | 2009-08-25 |
| Last Update Date | 2018-07-03 |
| Authorized Official Name | KARINA MARIE CLAYTON (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 6018257280 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
AL | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | 116354 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639644826 | Family Health Care Clinic, Inc. | Clinic/Center | 150 J E Johnson Rd, Prentiss, MS 39474-3101 | 2018-10-04 |
| 1083087985 | Family Health Care Clinic, Inc. | Clinic/Center | 102 Blackmur Dr, Water Valley, MS 38965 | 2015-11-02 |
| 1437412996 | Family Health Care Clinic, Inc. | Clinic/Center | 5096 Highway 49, Piney Woods, MS 39148 | 2012-06-20 |
| 1588992333 | Family Health Care Clinic, Inc. | Clinic/Center | 16410 Highway 72, Rogersville, AL 35652 | 2009-12-04 |
| 1881827434 | Family Health Care Clinic, Inc. | Clinic/Center | 125 School Rd, Mize Attendance Center, Mize, MS 39116 | 2009-08-31 |
| 1487887022 | Family Health Care Clinic, Inc. | Clinic/Center | 130 Lexie Road, Tylertown, MS 39429 | 2009-08-31 |
| 1801029467 | Family Health Care Clinic, Inc. | Clinic/Center | 125 Carter Street, Calhoun City, MS 38916 | 2009-08-31 |
| 1952534505 | Family Health Care Clinic, Inc. | Clinic/Center | 592 Schoolhouse Rd, Pinola, MS 39149 | 2009-08-31 |
| 1376776930 | Family Health Care Clinic, Inc. | Clinic/Center | 225 Saint Paul Road, Tylertown, MS 39667 | 2009-08-31 |
| 1720211386 | Family Health Care Clinic, Inc. | Clinic/Center | 1823 Highway 24 West, Woodville, MS 39669 | 2009-08-31 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | FAMILY HEALTH CARE CLINIC, INC. | 4635 Highway 80 E, Pearl, MS 39208-4226 |
| Street Address |
318 COFFEE AVE NE |
| City | RUSSELLVILLE |
| State | AL |
| Zip Code | 35653 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225360316 | Shannon Craig White | Nurse Practitioner | 318 Coffee Ave Ne, Russellville, AL 35653-2331 | 2010-02-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902384720 | Randy Wade Gooch | Pharmacist | 13675 Us-43, Russellville, AL 35653 | 2018-08-02 |
| 1700301470 | Carole Ann Montgomery | Pharmacist | Walmart Pharmacy, 13675 Us-43, Russellville, AL 35653 | 2017-08-03 |
| 1548632755 | Amanda Carrie Franks | Health Educator | 265 Skyline Dr, Russellville, AL 35653 | 2015-10-27 |
| 1023411220 | Wesley Charles Mayfield | Pharmacist | 14001 Hwy 43 Suite 13, Russellville, AL 35653 | 2014-10-01 |
| 1538371075 | Eyedocs On Wheels PC | Optometrist | 15255 Hwy 43, Russellville, AL 35653 | 2007-05-04 |
| 1063634574 | Russellville Physician Practices LLC | Orthopaedic Surgery | 715 Gandy Street Ne, Suite B, Russellville, AL 35653 | 2007-05-03 |
| 1750404141 | Alabama Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 14695 Hwy 43, Russellville, AL 35653 | 2007-04-09 |
| 1629111703 | Franklin County Health Dept Offsite Epsdt | Public Health or Welfare | 801 Highway 48, Russellville, AL 35653 | 2007-02-15 |
| 1750457941 | Southern Rural Health Care Consortium, Inc. | Clinic/Center | 318 Coffee Avenue, Russellville, AL 35653 | 2006-11-28 |
| 1861577900 | Southern Rural Health Care Consortium | Clinic/Center | 508 St Claire Se, Russellville, AL 35653 | 2006-10-26 |
| Find all providers in zip 35653 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750457941 | Southern Rural Health Care Consortium, Inc. | Clinic/Center | 318 Coffee Avenue, Russellville, AL 35653 | 2006-11-28 |
| 1861577900 | Southern Rural Health Care Consortium | Clinic/Center | 508 St Claire Se, Russellville, AL 35653 | 2006-10-26 |
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| 1982172367 | Health Services, Inc | Clinic/Center | 3350 S Court St, Montgomery, AL 36105-1606 | 2018-11-05 |
| 1932627858 | Whatley Health Services, Inc. | Clinic/Center | 417 3rd St Se, Aliceville, AL 35442 | 2017-08-30 |
| 1780123372 | Quality of Life Health Services, Inc | Clinic/Center | 404 9th Ave Sw, Lafayette, AL 36862-2806 | 2017-02-16 |
| 1487104691 | Whatley Health Services Inc | Clinic/Center | 142 School Street, Oakman, AL 35579 | 2016-10-12 |
| 1831568237 | Quality of Life Health Services, Inc | Clinic/Center | 1502 11th Ave, Phenix City, AL 36867-4905 | 2015-09-16 |
| 1477939031 | Whatley Health Services, Inc. | Clinic/Center | 3601 Stillman Blvd, Tuscaloosa, AL 35401-2601 | 2015-08-06 |
| Find all providers with the same taxonomy | ||||
| City | RUSSELLVILLE |
| Zip Code | 35653 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.