Healthcare Provider Details

I. General information

NPI: 1871502617
Provider Name (Legal Business Name): COMPLETE NURSING SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5001 JVC RD
COTTONDALE AL
35453-1901
US

IV. Provider business mailing address

5001 JVC RD
COTTONDALE AL
35453-1901
US

V. Phone/Fax

Practice location:
  • Phone: 205-556-9611
  • Fax: 205-556-9935
Mailing address:
  • Phone: 205-556-9611
  • Fax: 205-556-9935

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number059L
License Number StateAL

VIII. Authorized Official

Name: MRS. CAROL GEER
Title or Position: ADMINISTRATOR
Credential: ADMINISTRATOR
Phone: 205-556-9611