Healthcare Provider Details
I. General information
NPI: 1710929294
Provider Name (Legal Business Name): INFIRMARY HOME HEALTH AGENCY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/11/2006
Last Update Date: 12/04/2024
Certification Date: 12/04/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
851 E I65 SERVICE RD S STE 1000
MOBILE AL
36606-3100
US
IV. Provider business mailing address
PO BOX 51266
LAFAYETTE LA
70505-1266
US
V. Phone/Fax
- Phone: 251-450-3300
- Fax: 251-450-3307
- Phone: 337-233-1307
- Fax: 337-233-5764
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | N/A |
| License Number State | AL |
VIII. Authorized Official
Name: MR.
JOSHUA
L.
PROFFITT
Title or Position: PRESIDENT
Credential:
Phone: 337-233-1307