Healthcare Provider Details

I. General information

NPI: 1073885422
Provider Name (Legal Business Name): HOMEMED DIAGNOSTIC SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2012
Last Update Date: 02/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

328 S SAGE AVE STE 307C
MOBILE AL
36606-3629
US

IV. Provider business mailing address

328 S SAGE AVE STE 307C
MOBILE AL
36606-3629
US

V. Phone/Fax

Practice location:
  • Phone: 251-709-1131
  • Fax: 251-650-1681
Mailing address:
  • Phone: 251-709-1131
  • Fax: 251-650-1681

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: DR. TIMOTHY M ILIFF
Title or Position: PRESIDENT
Credential: M.D.
Phone: 251-709-1131