Healthcare Provider Details

I. General information

NPI: 1609958206
Provider Name (Legal Business Name): ALBERTVILLE HEALTHCARE CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2006
Last Update Date: 01/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 AL HIGHWAY 75 N
ALBERTVILLE AL
35951-4014
US

IV. Provider business mailing address

750 AL HIGHWAY 75 N
ALBERTVILLE AL
35951-4014
US

V. Phone/Fax

Practice location:
  • Phone: 256-878-1398
  • Fax: 256-878-6949
Mailing address:
  • Phone: 256-878-1398
  • Fax: 256-878-6949

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number12623
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MRS. PATTI WALLACE
Title or Position: CHAIRMAN OF THE BOARD
Credential:
Phone: 334-273-9002