Healthcare Provider Details

I. General information

NPI: 1740287085
Provider Name (Legal Business Name): MEDIREST, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2005
Last Update Date: 01/22/2026
Certification Date: 01/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 OXMOOR RD STE 134
BIRMINGHAM AL
35209
US

IV. Provider business mailing address

104 OXMOOR RD STE 134
BIRMINGHAM AL
35209-5937
US

V. Phone/Fax

Practice location:
  • Phone: 205-942-1616
  • Fax: 205-942-1008
Mailing address:
  • Phone: 205-942-1616
  • Fax: 205-942-1008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number128
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License Number128
License Number StateAL
# 4
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number128
License Number StateAL
# 5
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number128
License Number StateAL

VIII. Authorized Official

Name: JAMES D FALLON
Title or Position: PRESIDENT
Credential:
Phone: 205-942-1616