Healthcare Provider Details

I. General information

NPI: 1699979997
Provider Name (Legal Business Name): ENTERPRISES 101, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2007
Last Update Date: 04/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 ZELDA RD SUITE 200-4
MONTGOMERY AL
36106-3700
US

IV. Provider business mailing address

2800 ZELDA RD SUITE 200-4
MONTGOMERY AL
36106-3700
US

V. Phone/Fax

Practice location:
  • Phone: 334-213-0300
  • Fax: 334-213-0303
Mailing address:
  • Phone: 334-213-0300
  • Fax: 334-213-0303

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number4037
License Number StateAL

VIII. Authorized Official

Name: MR. SOLOMON MORRIS ROUSSO
Title or Position: CEO, AUDIOPROSTHOLOGIST
Credential: BC-HIS, ACA
Phone: 334-213-0300