1023107752 NPI number — ALMA RESPIRATORY SERVICES, LLC

Table of content: (NPI 1023107752)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023107752 NPI number — ALMA RESPIRATORY SERVICES, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALMA RESPIRATORY SERVICES, 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:
6
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:
1023107752
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/09/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2230 TOWNE LAKE PARKWAY
Provider Second Line Business Mailing Address:
BLDG 200 STE 100
Provider Business Mailing Address City Name:
WOODSTOCK
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30189-5540
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
727-321-0848
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4790 WHARF PKWY
Provider Second Line Business Practice Location Address:
BLDG F-208 OFFICE C
Provider Business Practice Location Address City Name:
ORANGE BEACH
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
36561-9614
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
727-321-0848
Provider Business Practice Location Address Fax Number:
727-328-9452
Provider Enumeration Date:
10/12/2006

Additional Information

Authorized Official

Authorized Official Last Name:
DONALD
Authorized Official First Name:
DALLAS
Authorized Official Middle Name:
C
Authorized Official Title or Position:
VICE PRESIDENT PATIENT SERVICES
Authorized Official Telephone Number:
678-401-2628

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 113550000 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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