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General NPI Number Information
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NPI Number | 1265533202
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Entity Type | Organization
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Legal Business Name | ALPHA-OMEGA HOSPICE LLC
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Dates
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Enumeration Date | 09/25/2006
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Last Update Date | 08/08/2007
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Provider Practice Location Address
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Address Line | 1017 W PUSHMATAHA ST
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City | BUTLER
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State | AL
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Zip | 36904-2443
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Country | US
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Telephone | 205-459-3917
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Fax | 205-459-3479
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Provider Business Mailing Address
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Address Line | PO BOX 553
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City | BUTLER
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State | AL
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Zip | 36904-0553
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Country | US
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Telephone | 205-459-3917
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Fax | 205-459-3479
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Authorized Official
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Title or Position | OWNER/ADMINISTRATOR
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Name | LAURA L SEGREST
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Credential | RN, MSN
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Telephone | 205-459-3917
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State | AL
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