Healthcare Provider Details

I. General information

NPI: 1457707143
Provider Name (Legal Business Name): ESSENTIAL HOME CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2016
Last Update Date: 05/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2837 E SOUTH BLVD UNIT 20213
MONTGOMERY AL
36120-3010
US

IV. Provider business mailing address

2837 E SOUTH BLVD UNIT 20213
MONTGOMERY AL
36120-3010
US

V. Phone/Fax

Practice location:
  • Phone: 334-245-4341
  • Fax:
Mailing address:
  • Phone: 334-245-4341
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
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 Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: ANNIE WHITE
Title or Position: OPERATIONS DIRECTOR
Credential: SW
Phone: 334-245-4341