Healthcare Provider Details

I. General information

NPI: 1952058976
Provider Name (Legal Business Name): CENTRAL ALABAMA LACTATION SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2022
Last Update Date: 03/09/2022
Certification Date: 03/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8298 WADE RD
WARRIOR AL
35180-3016
US

IV. Provider business mailing address

8298 WADE RD
WARRIOR AL
35180-3016
US

V. Phone/Fax

Practice location:
  • Phone: 205-902-1468
  • Fax: 205-378-3886
Mailing address:
  • Phone: 205-902-1468
  • Fax: 205-378-3886

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number
License Number State

VIII. Authorized Official

Name: MRS. HEIDI HENDERSON POWELL
Title or Position: OWNER, LACTATION CONSULTANT
Credential: RN, IBCLC
Phone: 205-902-1468