| Name: | Total Family Health Care Center, L.L.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 05 May 2005 (20 years ago) |
| Entity Number: | 000-463-895 |
| Register Number: | 000463895 |
| County: | De Kalb |
| Place of Formation: | DeKalb County |
| Principal Address: | FT PAYNE, AL |
| Registered Office Street Address: | 1214 FORST AVE NFT PAYNE, AL 35967 |
| Registered Office Street Address ZIP Code: | 35967 |
Activities
ANY LAWFUL ACTIVITY
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1285792044 | 2006-12-05 | 2020-08-22 | 2804 GREENHILL BLVD NW, SUITE 101, FORT PAYNE, AL, 359683029, US | 2804 GREENHILL BLVD NW, SUITE 101, FORT PAYNE, AL, 359683029, US | |||||||||||||||||||||||||
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| Phone | +1 256-844-2943 |
| Fax | 2568442939 |
Authorized person
| Name | MRS. MINDY TURNER |
| Role | OFFICE MANAGER |
| Phone | 2568442943 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | D0704 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSS BLUE SHIELD |
| Number | 51001927 |
| State | AL |
| Name | Role |
|---|---|
| BLOOME, ROBERT S | Agent |
| Name | Role |
|---|---|
| BLOOME, ROBERT S | Member |
Date of last update: 14 Aug 2024
Sources: Alabama Secretary of State
