Healthcare Provider Details

I. General information

NPI: 1336683135
Provider Name (Legal Business Name): HECA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2016
Last Update Date: 12/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119 LONGWOOD DR SW
HUNTSVILLE AL
35801-4522
US

IV. Provider business mailing address

2007 GALLATIN ST SW
HUNTSVILLE AL
35801-4561
US

V. Phone/Fax

Practice location:
  • Phone: 256-533-6488
  • Fax: 256-534-7372
Mailing address:
  • Phone: 256-533-6488
  • Fax: 256-534-7372

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHAEL WAYNE BROWN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 256-533-6488