Healthcare Provider Details
I. General information
NPI: 1336890250
Provider Name (Legal Business Name): VULCAN HEALTHCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/12/2022
Last Update Date: 01/12/2022
Certification Date: 01/10/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7063 VETERANS PKWY # 200
PELL CITY AL
35125-5114
US
IV. Provider business mailing address
#376 732 MONTGOMERY HIGHWAY
VESTAVIA AL
35216
US
V. Phone/Fax
- Phone: 205-777-9574
- Fax:
- Phone: 205-777-9574
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 213ES0131X |
| Taxonomy | Foot Surgery Podiatrist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
GEOFFREY
H
DYE
Title or Position: PRESIDENT
Credential: DPM
Phone: 205-777-9574