Organization
SOUTHERN FAMILY HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JACKIE FREDERICK CRNP (OWNER)
(205) 669-4884
Entity
Organization
Contact information
Practice address
201 OLD HIGHWAY 25 EAST, COLUMBIANA, AL 35051
(205) 669-4884
Mailing address
201 OLD HIGHWAY 25 E, COLUMBIANA, AL 35051-9373
(205) 669-4884
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
1029953
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
541003915
—
AL
Enumeration date
06/05/2014
Last updated
06/05/2014
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