1437220456 NPI number — ADORATION HOSPICE CARE ALABAMA, LLC

Table of content: (NPI 1437220456)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437220456 NPI number — ADORATION HOSPICE CARE ALABAMA, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ADORATION HOSPICE CARE ALABAMA, 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:
HOSPICE SERVICES OF ALABAMA
Provider Other Organization Name Type Code:
3
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:
1437220456
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/03/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1000 SOUTHLAKE PARK STE 100
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BIRMINGHAM
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35244-5700
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
205-682-9996
Provider Business Mailing Address Fax Number:
205-682-9994

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1631 HAMRIC DR E
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OXFORD
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
36203-2035
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-682-9996
Provider Business Practice Location Address Fax Number:
205-682-9994
Provider Enumeration Date:
11/13/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MATTINGLY
Authorized Official First Name:
ANGIE
Authorized Official Middle Name:
Authorized Official Title or Position:
MANAGER PROVIDER ENROLLMENT
Authorized Official Telephone Number:
502-381-3579

Provider Taxonomy Codes

  • Taxonomy code: 251G00000X , with the licence number:  11683 , 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: PIC1629E , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 012537 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".




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