Healthcare Provider Details

I. General information

NPI: 1588693550
Provider Name (Legal Business Name): NEW BEACON HEALTHCARE GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2006
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 S HOUSTON ST
SCOTTSBORO AL
35768-4319
US

IV. Provider business mailing address

PO BOX 4060 ATTN: REGULATORY
MOORESVILLE NC
28117-4060
US

V. Phone/Fax

Practice location:
  • Phone: 256-574-4622
  • Fax: 256-259-3772
Mailing address:
  • Phone: 704-664-2876
  • Fax: 704-230-0946

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER TYLER
Title or Position: VP OF REGULATORY COUNSEL
Credential:
Phone: 704-664-2876