MEDICARE: HUNTLEIGH HEALTHCARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies	620	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	515 14737	OTHER	AL	BC BS

General Provider Information

NPI Number	:	1134246192
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HUNTLEIGH HEALTHCARE LLC

Provider Business Mailing Address
First Line	:	40 CHRISTOPHER WAY
Second Line	:
City	:	EATONTOWN
State	:	NJ
Zip	:	07724-3327
Country	:	US
Telephone Number	:	800-223-1218
Fax Number	:	732-676-1096

Provider Business Practice Location Address
First Line	:	2441 1ST AVE S
Second Line	:
City	:	IRONDALE
State	:	AL
Zip	:	35210-1540
Country	:	US
Telephone Number	:	205-957-1193
Fax Number	:	205-957-1194

Authorized Official
Title or Position	:	PRES.
Name	:	MR. ROBERT S. ANGEL
Credential	:
Telephone Number	:	800-223-1218

Provider Enumeration Date	:	03/23/2007
Last Update Date	:	11/13/2007

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Directions to “HUNTLEIGH HEALTHCARE LLC ” Practice Location

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