Healthcare Provider Details

I. General information

NPI: 1184616906
Provider Name (Legal Business Name): HOSPITAL EQUIPMENT AND HOME NUTRITIONAL THERAPY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

727 MEMORIAL DR
BESSEMER AL
35022-6029
US

IV. Provider business mailing address

119 HIGHLANDER DR
HUEYTOWN AL
35023-2720
US

V. Phone/Fax

Practice location:
  • Phone: 205-428-5113
  • Fax: 205-424-6786
Mailing address:
  • Phone: 205-491-6836
  • Fax: 205-424-6786

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number05001347
License Number StateAL

VIII. Authorized Official

Name: MR. CHARLES RAY WALL
Title or Position: PRESIDENT
Credential: RPH
Phone: 205-428-5113