Healthcare Provider Details

I. General information

NPI: 1093535213
Provider Name (Legal Business Name): BELLE AME PCS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2024
Last Update Date: 10/14/2024
Certification Date: 10/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 DOWNTOWNER LOOP W STE H101
MOBILE AL
36609-5528
US

IV. Provider business mailing address

750 DOWNTOWNER LOOP W STE H101
MOBILE AL
36609-5528
US

V. Phone/Fax

Practice location:
  • Phone: 470-696-6176
  • Fax:
Mailing address:
  • Phone: 470-696-6176
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: RODNEY EVANS
Title or Position: ADMINISTRATOR
Credential:
Phone: 470-696-6176