Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Primary Care |
261QP2300X | |||
Clinic/Center |
261Q00000X | |||
General Practice |
208D00000X | 99 | Physician/Undefined Physician type[6] | |
Urgent Care |
261QU0200X |
| NPI Number | 1508292657 |
||||
| LBN Legal business name | AMERICAN FAMILY CARE, LLC | ||||
| Authorized official | RANDY JOHANSEN - (PRESIDENT) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | Yes | ||||
| Enumeration date | 09/20/2013 | ||||
| Last updated | 03/27/2025 - More than a year ago | ||||
| Identifiers |
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