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General NPI Number Information
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NPI Number | 1669136081
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Entity Type | Organization
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Legal Business Name | NORTHEAST ALABAMA HOMECARE LLC
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Dates
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Enumeration Date | 10/22/2021
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Last Update Date | 12/29/2023
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Provider Practice Location Address
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Address Line | 4171 AL HIGHWAY 71
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City | DUTTON
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State | AL
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Zip | 35744-8547
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Country | US
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Telephone | 256-630-0218
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 252
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City | DUTTON
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State | AL
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Zip | 35744-0252
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AMANDA LAW FOSHEE
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Credential |
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Telephone | 256-833-9001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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