MEDICARE: PHP OF ALABAMA

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3104A0625X	Assisted Living Facility (Mental Illness)	480	AL

General Provider Information

NPI Number	:	1437159290
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHP OF ALABAMA

Provider Business Mailing Address
First Line	:	62 RED EAGLE PKWY
Second Line	:
City	:	WETUMPKA
State	:	AL
Zip	:	36092-2052
Country	:	US
Telephone Number	:	334-567-3729
Fax Number	:	334-514-6776

Provider Business Practice Location Address
First Line	:	62 RED EAGLE PKWY
Second Line	:
City	:	WETUMPKA
State	:	AL
Zip	:	36092-2052
Country	:	US
Telephone Number	:	334-567-3729
Fax Number	:	334-514-6776

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. JON BURNS
Credential	:
Telephone Number	:	334-567-3729

Provider Enumeration Date	:	07/22/2005
Last Update Date	:	08/22/2020

Similar Medicare Providers

1467599282 — PHP OF ALABAMA, INC.
Practice Location Address:

62 RED EAGLE PKWY
WETUMPKA, AL
36092-2052

Practice Phone: 334-567-3729
Practice Fax: 334-514-6776

1558358549 — HELPING HEARTS HOSPICE
Practice Location Address:

225 HILL ST
WETUMPKA, AL
36092-2722

Practice Phone: 334-512-1010
Practice Fax: 334-512-1013

1245202902 — DR. DAVID S GAMS M.D.
Practice Location Address:

8966 US HIGHWAY 231
WETUMPKA, AL
36092-5375

Practice Phone: 334-514-9723
Practice Fax: 334-259-2621

1265408603 — STEVEN MARK HAYDEN M.D.
Practice Location Address:

76297 TALLASSEE HWY
WETUMPKA, AL
36092-5558

Practice Phone: 334-514-1910
Practice Fax:

1235106543 — WILLIE J CHESTER DO
Practice Location Address:

4452 US HIGHWAY 231
WETUMPKA, AL
36092-3328

Practice Phone: 334-420-5001
Practice Fax: 334-293-6640

1063476489 — PHYSICIANS CHOICE DIALYSIS OF ALABAMA LLC
Practice Location Address:

125 HOSPITAL DRIVE
WETUMPKA, AL
36092-1626

Practice Phone: 334-514-2037
Practice Fax: 334-514-9568

Directions to “PHP OF ALABAMA ” Practice Location

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