Organization
ROBRICH ENTERPRISE LLC
Active
Other names
Robertson Medical
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. FAYE ANN ROBERTSON FNP-C (OWNER/PROVIDER)
(662) 251-5664
Entity
Organization
Contact information
Practice address
105 4TH ST NW, REFORM, AL 35481-2351
(662) 251-5664
Mailing address
PO BOX 141, REFORM, AL 35481-0141
(662) 251-5664
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1639614563
INDIVIDUAL NPI
—
Enumeration date
06/09/2023
Last updated
06/09/2023
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