MEDICARE: NEW BEACON HEALTHCARE GROUP, 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	251G00000X	Community Based Hospice Care Agency	APPLIED FOR	AL

General Provider Information

NPI Number	:	1568645711
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW BEACON HEALTHCARE GROUP, LLC

Provider Business Mailing Address
First Line	:	2151 HIGHLAND AVE S
Second Line	:	SUITE 350
City	:	BIRMINGHAM
State	:	AL
Zip	:	35205-4079
Country	:	US
Telephone Number	:	205-939-8711
Fax Number	:	205-939-8778

Provider Business Practice Location Address
First Line	:	1111 E I65 SERVICE RD S
Second Line	:	SUITE 207
City	:	MOBILE
State	:	AL
Zip	:	36606-3112
Country	:	US
Telephone Number	:	205-939-8711
Fax Number	:

Authorized Official
Title or Position	:	CEO AND PRESIDENT
Name	:	MR. JOHN E MORRIS
Credential	:
Telephone Number	:	205-939-8711

Provider Enumeration Date	:	12/11/2007
Last Update Date	:	12/11/2007

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