MEDICARE: HGA HOME MEDICAL EQUIPMENT, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	332BP3500X	Parenteral & Enteral Nutrition Supplies (DME)
2	332B00000X	Durable Medical Equipment & Medical Supplies
3	332BX2000X	Oxygen Equipment & Supplies (DME)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1245685981
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HGA HOME MEDICAL EQUIPMENT, LLC

Provider Business Mailing Address
First Line	:	406 MEDICAL CENTER DR.
Second Line	:
City	:	JASPER
State	:	AL
Zip	:	35501-3400
Country	:	US
Telephone Number	:	205-221-8200
Fax Number	:	205-221-8270

Provider Business Practice Location Address
First Line	:	1111 S. RALEIGH AVE.
Second Line	:	STE. 900
City	:	SHEFFIELD
State	:	AL
Zip	:	35660-6350
Country	:	US
Telephone Number	:	256-766-7015
Fax Number	:	256-766-7016

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	LISA J. WELLS
Credential	:	CPCO
Telephone Number	:	205-221-8258

Provider Enumeration Date	:	05/02/2016
Last Update Date	:	11/13/2019

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Directions to “HGA HOME MEDICAL EQUIPMENT, LLC ” Practice Location

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