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General NPI Number Information
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NPI Number | 1619354149
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Entity Type | Organization
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Legal Business Name | PROHEALTH OF NORTH CENTRAL ALABAMA, LLC
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Dates
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Enumeration Date | 05/05/2015
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Last Update Date | 05/01/2019
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Provider Practice Location Address
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Address Line | 923 2ND AVE E
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City | ONEONTA
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State | AL
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Zip | 35121-2505
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Country | US
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Telephone | 205-820-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 717 37TH ST S
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City | BIRMINGHAM
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State | AL
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Zip | 35222-3244
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Country | US
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Telephone | 205-820-7000
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Fax |
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Authorized Official
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Title or Position | GENERAL COUNSEL
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Name | MR. DAVID A LESTER
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Credential | JD
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Telephone | 205-820-7000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 2668-H
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License Number State | AL
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