MEDICARE: HEALTHGROUP OF ALABAMA, 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	251E00000X	Home Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	51516749	OTHER	AL	BLUE CROSS BLUE SHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	5753137	OTHER		AETNA

General Provider Information

NPI Number	:	1821061656
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTHGROUP OF ALABAMA, LLC

Provider Business Mailing Address
First Line	:	6767 OLD MADISON PIKE
Second Line	:	STE 400
City	:	HUNTSVILLE
State	:	AL
Zip	:	35806-2172
Country	:	US
Telephone Number	:	256-922-6650
Fax Number	:	256-922-6651

Provider Business Practice Location Address
First Line	:	6767 OLD MADISON PIKE
Second Line	:	STE 400
City	:	HUNTSVILLE
State	:	AL
Zip	:	35806-2172
Country	:	US
Telephone Number	:	256-922-6650
Fax Number	:	256-922-6651

Authorized Official
Title or Position	:	CEO
Name	:	MR. PHILIP E. DOTSON
Credential	:
Telephone Number	:	256-922-6680

Provider Enumeration Date	:	02/10/2006
Last Update Date	:	10/24/2007

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Directions to “HEALTHGROUP OF ALABAMA, LLC ” Practice Location

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