COOSA FAMILY CARE LLC NPI 1578113221

NPI Information

COOSA FAMILY CARE LLC is a primary care clinic center in Rainbow City, AL. COOSA FAMILY CARE LLC NPI is 1578113221. The provider is registered as an organization entity type.

The provider's business location address is:

310 W GRAND AVE
RAINBOW CITY, AL
ZIP 35906
Phone: (256) 459-5132
Fax: (256) 459-5179

The provider's authorized official is Kristopher Holder .
The authorized official title is Owner/manager and has the following contact phone number (256) 459-5132.

The CLIA number assigned to this NPI record is 01D2150724 - independent with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 9/15/2019 and was last updated on 10/31/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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