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General NPI Number Information
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NPI Number | 1245214006
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Entity Type | Organization
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Legal Business Name | EAST ALABAMA HOMEMED LLC
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Dates
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Enumeration Date | 12/05/2005
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Last Update Date | 05/15/2024
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Provider Practice Location Address
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Address Line | 1908 PEPPERELL PKWY SUITE 2
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City | OPELIKA
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State | AL
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Zip | 36801-5473
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Country | US
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Telephone | 334-741-7410
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Fax | 334-742-0032
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Provider Business Mailing Address
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Address Line | PO BOX 4043
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City | OPELIKA
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State | AL
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Zip | 36803-4043
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Country | US
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Telephone | 334-741-7410
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Fax | 334-742-0032
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Authorized Official
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Title or Position | CHIEF COMPLIANCE OFFICER
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Name | MR. DANIEL BRETT STOUTE
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Credential |
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Telephone | 337-500-1977
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number | 557
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License Number State | AL
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