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General NPI Number Information
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NPI Number | 1922410497
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Entity Type | Organization
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Legal Business Name | CAPITOL CITY HOME HEALTH AND REHAB
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Dates
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Enumeration Date | 06/02/2014
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Last Update Date | 06/02/2014
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Provider Practice Location Address
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Address Line | 8202 OLD FEDERAL RD STE A
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City | MONTGOMERY
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State | AL
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Zip | 36117-8030
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Country | US
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Telephone | 334-590-8087
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Fax |
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Provider Business Mailing Address
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Address Line | 8853 CHANTILLY WAY
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City | MONTGOMERY
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State | AL
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Zip | 36116-6672
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Country | US
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Telephone | 334-590-8087
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. JESSE HERBERT SCOTT JR.
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Credential | OWNER
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Telephone | 334-590-8087
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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 | 12649
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License Number State | AL
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