Healthcare Provider Details

I. General information

NPI: 1639012024
Provider Name (Legal Business Name): RUSSELL & RUSSELL ENTERPRISE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2026
Last Update Date: 04/11/2026
Certification Date: 04/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8621 9TH CT S
BIRMINGHAM AL
35206-3506
US

IV. Provider business mailing address

PO BOX 380184
BIRMINGHAM AL
35238-0184
US

V. Phone/Fax

Practice location:
  • Phone: 205-222-0010
  • Fax:
Mailing address:
  • Phone: 205-222-0010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateNULL
# 4
Primary TaxonomyY
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number StateNULL

VIII. Authorized Official

Name: CEARA NORMAN
Title or Position: OWNER
Credential:
Phone: 205-222-0010