1104805548 NPI number — HAPPY HOME HEALTH LLC

Table of content: (NPI 1104805548)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1104805548 NPI number — HAPPY HOME HEALTH LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HAPPY HOME HEALTH LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1104805548
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1183
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ALABASTER
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35007-2057
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
205-620-6677
Provider Business Mailing Address Fax Number:
205-620-6699

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
300 APPLEGATE PKWY
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
PELHAM
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35124-2940
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-620-6677
Provider Business Practice Location Address Fax Number:
205-620-6699
Provider Enumeration Date:
01/13/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BRYANT
Authorized Official First Name:
PAUL
Authorized Official Middle Name:
J
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
205-620-6677

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , with the licence number:  387 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0007880329 . This is a "AETNA INSURANCE" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 51097211 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".