Healthcare Provider Details

I. General information

NPI: 1629228564
Provider Name (Legal Business Name): MEDCARE LIFE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2008
Last Update Date: 09/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2517 30TH AVE NORTH
BIRMINGHAM AL
35207
US

IV. Provider business mailing address

2517 30TH AVE NORTH
BIRMINGHAM AL
35207
US

V. Phone/Fax

Practice location:
  • Phone: 205-251-1239
  • Fax: 205-251-1066
Mailing address:
  • Phone: 205-251-1239
  • Fax: 205-251-1066

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number08018232
License Number StateAL

VIII. Authorized Official

Name: MR. MARCUS EUGENE PICKETT
Title or Position: CEO
Credential: DIRTRICT SALES MGR
Phone: 205-251-1239