Provider Demographics
NPI:1447501929
Name:RCHP-FLORENCE, LLC
Entity type:Organization
Organization Name:RCHP-FLORENCE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:E
Authorized Official - Last Name:HOBBS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-768-9191
Mailing Address - Street 1:PO BOX 10005
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35631-2005
Mailing Address - Country:US
Mailing Address - Phone:256-386-1130
Mailing Address - Fax:256-386-1132
Practice Address - Street 1:203 AVALON AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:MUSCLE SHOALS
Practice Address - State:AL
Practice Address - Zip Code:35661-2869
Practice Address - Country:US
Practice Address - Phone:256-386-1130
Practice Address - Fax:256-386-1132
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RCHP-FLORENCE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-09-25
Last Update Date:2012-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL102G706051Medicare PIN