Healthcare Provider Details

I. General information

NPI: 1578844650
Provider Name (Legal Business Name): ENCOMPASS MEDICAL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2011
Last Update Date: 09/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4128 CROSSHAVEN DRIVE
VESTAVIA HILLS AL
35243-5228
US

IV. Provider business mailing address

4128 CROSSHAVEN DRIVE
VESTAVIA HILLS AL
35243-5228
US

V. Phone/Fax

Practice location:
  • Phone: 205-969-7466
  • Fax: 205-969-1600
Mailing address:
  • Phone: 205-969-7466
  • Fax: 205-969-1600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: MR. JACK N DUNN JR.
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 205-969-7466