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NPI Code Detail

MEDICARE: NUTRIFOCUS

MEDICARE: NUTRIFOCUS
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
1261Q00000XClinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1511-28637OTHERALBCBS-AL

General Provider Information

NPI Number : 1558992396
Entity Type Code : Organization
Provider Name (Legal Business Name) : NUTRIFOCUS
Provider Business Mailing Address
First Line : 111 OGLESBY AVE
Second Line :
City : BIRMINGHAM
State : AL
Zip : 35209-6227
Country : US
Telephone Number : 205-317-4111
Fax Number :
Provider Business Practice Location Address
First Line : 4126 AUTUMN LN
Second Line :
City : VESTAVIA
State : AL
Zip : 35243-5209
Country : US
Telephone Number : 205-317-4111
Fax Number :
Authorized Official
Title or Position : OWNER
Name : MRS. SUZANNE ELEAZER PIRKLE
Credential : MA,RD,LD,CEDRD
Telephone Number : 205-317-4111
Provider Enumeration Date : 01/30/2020
Last Update Date : 01/30/2020

Similar Medicare Providers

1912692153 — JANELLE JENSEN FRITZ
Practice Location Address:
4126 AUTUMN LN
VESTAVIA, AL
35243-5209
Practice Phone: 205-967-3277
Practice Fax:
1629298518 — MS. LUCY CAROLINE NICHOLS LCSW, PIP
Practice Location Address:
4126 AUTUMN LN
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35243-5209
Practice Phone: 205-515-7784
Practice Fax:
1346646569 — SUZANNE PIRKLE MA,RD,LD
Practice Location Address:
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35243-5209
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Practice Fax: 205-536-6223
1306396049 — AMY LISCOMB RDN, LD
Practice Location Address:
4126 AUTUMN LN
VESTAVIA, AL
35243-5209
Practice Phone: 205-317-4111
Practice Fax:
1720666290 — CLAYTON DANIEL HIGHTOWER LICSW
Practice Location Address:
4126 AUTUMN LN
VESTAVIA, AL
35243-5209
Practice Phone: 205-967-3277
Practice Fax:
1346323268 — MRS. PAMELLA JOYCE MOORE LCSW
Practice Location Address:
4126 AUTUMN LN
BIRMINGHAM, AL
35243-5209
Practice Phone: 205-967-3277
Practice Fax: 205-967-3352

Directions to “NUTRIFOCUS ” Practice Location

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