Healthcare Provider Details

I. General information

NPI: 1568297539
Provider Name (Legal Business Name): KNOWBRA INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2024
Last Update Date: 09/07/2024
Certification Date: 09/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 1ST AVE N STE C112
BIRMINGHAM AL
35203-1865
US

IV. Provider business mailing address

8088 HIGHWAY 31 UNIT 8
CALERA AL
35040-3901
US

V. Phone/Fax

Practice location:
  • Phone: 205-478-7518
  • Fax:
Mailing address:
  • Phone: 205-478-7518
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: MRS. BRITTNEY BASS-GRAY
Title or Position: OWNER
Credential: CMF
Phone: 205-478-7518