Healthcare Provider Details

I. General information

NPI: 1972235091
Provider Name (Legal Business Name): BURNHAMS VITAL CARE OF ALABAMA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2022
Last Update Date: 07/14/2022
Certification Date: 07/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2724 OLD SHELL RD UNIT A
MOBILE AL
36607-2931
US

IV. Provider business mailing address

2724 OLD SHELL RD UNIT A
MOBILE AL
36607-2931
US

V. Phone/Fax

Practice location:
  • Phone: 251-460-1010
  • Fax: 251-301-9779
Mailing address:
  • Phone: 251-460-1010
  • Fax: 251-301-9779

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 TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: LINDSAY GRAHAM
Title or Position: MANAGER
Credential:
Phone: 251-460-1010