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General NPI Number Information
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NPI Number | 1407967938
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Entity Type | Organization
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Legal Business Name | FOUR SEASONS MEDICAL SUPPLY, INC
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 11/10/2009
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Provider Practice Location Address
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Address Line | 4201 BESSEMER SUPER HWY
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City | BESSEMER
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State | AL
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Zip | 35020-2412
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Country | US
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Telephone | 205-428-0147
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Fax | 205-425-7231
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Provider Business Mailing Address
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Address Line | 4201 BESSEMER SUPER HWY
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City | BESSEMER
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State | AL
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Zip | 35020-2412
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Country | US
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Telephone | 205-428-0147
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Fax | 205-425-7231
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Authorized Official
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Title or Position | BILLER
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Name | JEANNE TAYLOR
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Credential |
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Telephone | 205-428-0147
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BN1400X
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Taxonomy Name | Nursing Facility Supplies (DME)
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License Number | 06015325
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License Number State | AL
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