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General NPI Number Information
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NPI Number | 1841468238
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Entity Type | Organization
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Legal Business Name | CENTRAL ALABAMA FOOT CARE LLC
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Dates
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Enumeration Date | 02/19/2008
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Last Update Date | 07/29/2008
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Provider Practice Location Address
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Address Line | 875 FRIENDSHIP RD SUITE J
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City | TALLASSEE
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State | AL
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Zip | 36078-1234
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Country | US
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Telephone | 334-283-4178
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Fax | 334-283-2190
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Provider Business Mailing Address
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Address Line | PO BOX 780367
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City | TALLASSEE
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State | AL
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Zip | 36078-0004
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Country | US
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Telephone | 334-283-4178
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Fax | 334-283-2190
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. LYNNE B EADY
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Credential |
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Telephone | 334-283-4178
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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 | 71
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License Number State | AL
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