Healthcare Provider Details

I. General information

NPI: 1750736310
Provider Name (Legal Business Name): HGA HOME MEDICAL EQUIPMENT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2016
Last Update Date: 06/27/2023
Certification Date: 06/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1321 WAGNER DR STE 500
BOAZ AL
35957-5992
US

IV. Provider business mailing address

406 MEDICAL CENTER DR.
JASPER AL
35501-3400
US

V. Phone/Fax

Practice location:
  • Phone: 256-593-7450
  • Fax: 256-593-7452
Mailing address:
  • Phone: 205-221-8200
  • Fax: 205-221-8270

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: LISA J. WELLS
Title or Position: EXECUTIVE DIRECTOR
Credential: CPCD
Phone: 205-221-8258