Basic Information
| Provider Information | |||||||||
| NPI: | 1295080489 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | RCHP-FLORENCE, LLC | ||||||||
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| OtherOrganizationName: | SHOALS OCCUPATIONAL MEDICINE, INC. | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 10005 | ||||||||
| Address2: | |||||||||
| City: | FLORENCE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 356312005 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2567689191 | ||||||||
| FaxNumber: | 2567689775 | ||||||||
| Practice Location | |||||||||
| Address1: | 203 AVALON AVE | ||||||||
| Address2: | SUITE 270 | ||||||||
| City: | MUSCLE SHOALS | ||||||||
| State: | AL | ||||||||
| PostalCode: | 356612869 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2563861436 | ||||||||
| FaxNumber: | 2563861438 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/13/2012 | ||||||||
| LastUpdateDate: | 07/16/2012 | ||||||||
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| AuthorizedOfficialLastName: | HOBBS | ||||||||
| AuthorizedOfficialFirstName: | STEPHEN | ||||||||
| AuthorizedOfficialMiddleName: | E | ||||||||
| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 2567689191 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | RCHP-FLORENCE, LLC | ||||||||
| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2083X0100X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Preventive Medicine | Occupational Medicine |
No ID Information.