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General NPI Number Information
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NPI Number | 1568682078
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Entity Type | Organization
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Legal Business Name | AZALEA CITY MEDICAL SERVICES
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Dates
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Enumeration Date | 04/26/2007
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Last Update Date | 10/31/2014
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Provider Practice Location Address
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Address Line | 3046 DAUPHIN ISLAND PKWY
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City | MOBILE
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State | AL
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Zip | 36605-3835
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Country | US
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Telephone | 251-287-7067
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Fax | 251-461-6439
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Provider Business Mailing Address
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Address Line | 3046 DAUPHIN ISLAND PKWY
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City | MOBILE
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State | AL
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Zip | 36605-3835
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Country | US
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Telephone | 251-287-7067
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Fax | 251-461-6439
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Authorized Official
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Title or Position | OWNERPRESIDENT
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Name | DEBBIE KING
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Credential |
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Telephone | 251-287-7067
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251F00000X
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Taxonomy Name | Home Infusion Agency
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License Number | 111612
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 111612
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License Number State | AL
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