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General NPI Number Information
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NPI Number | 1629228564
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Entity Type | Organization
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Legal Business Name | MEDCARE LIFE LLC
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Dates
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Enumeration Date | 09/29/2008
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Last Update Date | 09/29/2008
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Provider Practice Location Address
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Address Line | 2517 30TH AVE NORTH
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City | BIRMINGHAM
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State | AL
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Zip | 35207
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Country | US
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Telephone | 205-251-1239
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Fax | 205-251-1066
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Provider Business Mailing Address
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Address Line | 2517 30TH AVE NORTH
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City | BIRMINGHAM
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State | AL
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Zip | 35207
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Country | US
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Telephone | 205-251-1239
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Fax | 205-251-1066
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Authorized Official
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Title or Position | CEO
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Name | MR. MARCUS EUGENE PICKETT
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Credential | DIRTRICT SALES MGR
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Telephone | 205-251-1239
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 08018232
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License Number State | AL
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