Basic Information
| Provider Information | |||||||||
| NPI: | 1336447507 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | RCHP-FLORENCE, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 10005 | ||||||||
| Address2: | |||||||||
| City: | FLORENCE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 356312005 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2567688349 | ||||||||
| FaxNumber: | 2567689775 | ||||||||
| Practice Location | |||||||||
| Address1: | 205 MARENGO ST | ||||||||
| Address2: | |||||||||
| City: | FLORENCE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 356306033 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2567689191 | ||||||||
| FaxNumber: | 2567689775 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/11/2011 | ||||||||
| LastUpdateDate: | 04/26/2022 | ||||||||
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| AuthorizedOfficialLastName: | DILLON | ||||||||
| AuthorizedOfficialFirstName: | TERRANCE | ||||||||
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| AuthorizedOfficialTitleorPosition: | ASSISTANT SECRETARY | ||||||||
| AuthorizedOfficialTelephone: | 5025967220 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 04/26/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | 367500000X | Y | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.