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General NPI Number Information
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NPI Number | 1417317488
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Entity Type | Organization
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Legal Business Name | PROFESSIONAL MED-HEALTH LLC
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Dates
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Enumeration Date | 03/03/2016
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Last Update Date | 03/03/2016
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Provider Practice Location Address
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Address Line | 1157 INVERNESS COVE WAY
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City | BIRMINGHAM
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State | AL
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Zip | 35242-4258
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Country | US
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Telephone | 251-298-0917
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Fax | 205-747-0133
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Provider Business Mailing Address
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Address Line | 1157 INVERNESS COVE WAY
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City | BIRMINGHAM
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State | AL
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Zip | 35242
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Country | US
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Telephone | 251-298-0917
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Fax | 205-747-0133
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Authorized Official
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Title or Position | CLINICAL MANAGER/OWNER
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Name | MIRANDA DAVIS
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Credential | RN
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Telephone | 251-298-0917
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State | AL
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