MEDICARE: MASH,INC.

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	080065	AL

General Provider Information

NPI Number	:	1578722468
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MASH,INC.

Provider Business Mailing Address
First Line	:	1215 MILITARY ST S
Second Line	:
City	:	HAMILTON
State	:	AL
Zip	:	35570-5004
Country	:	US
Telephone Number	:	205-486-9003
Fax Number	:	205-486-2828

Provider Business Practice Location Address
First Line	:	1215 MILITARY ST S
Second Line	:
City	:	HAMILTON
State	:	AL
Zip	:	35570-5004
Country	:	US
Telephone Number	:	205-486-9003
Fax Number	:	205-486-2828

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. STEVEN W ALVERSON
Credential	:
Telephone Number	:	205-486-9003

Provider Enumeration Date	:	06/05/2008
Last Update Date	:	06/05/2008

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