=====================================================
General NPI Number Information
=====================================================
NPI Number | 1588304430
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ISABINE INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/30/2022
-----------------------------------------------------
Last Update Date | 03/30/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3977 BURMA RD STE B
-----------------------------------------------------
City | MOBILE
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 36693-4523
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 864-344-7935
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3977 BURMA RD STE B
-----------------------------------------------------
City | MOBILE
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 36693-4523
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 864-344-7935
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR
-----------------------------------------------------
Name | MR. JOSEPH S HIRST III
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 864-344-7935
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------