=====================================================
General NPI Number Information
=====================================================
NPI Number | 1568468833
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | USA HEALTHCARE MORGAN LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/22/2005
-----------------------------------------------------
Last Update Date | 02/15/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2326 MORGAN AVE SW
-----------------------------------------------------
City | DECATUR
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35601-6244
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 256-340-5745
-----------------------------------------------------
Fax | 256-340-1281
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 1821
-----------------------------------------------------
City | DECATUR
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35602-1821
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 256-340-5745
-----------------------------------------------------
Fax | 256-340-1281
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR
-----------------------------------------------------
Name | GREGORY SCOTT HAYES
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 256-340-5745
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 314000000X
-----------------------------------------------------
Taxonomy Name | Skilled Nursing Facility
-----------------------------------------------------
License Number | 10632
-----------------------------------------------------
License Number State | AL
-----------------------------------------------------