Provider Demographics
NPI:1023021326
Name:NEWMANS HOME MEDICAL LLC
Entity Type:Organization
Organization Name:NEWMANS HOME MEDICAL LLC
Other - Org Name:NEWMAN'S HOME MEDICAL LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RONNIE
Authorized Official - Middle Name:J
Authorized Official - Last Name:NEWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-476-5555
Mailing Address - Street 1:3500 COTTAGE HILL RD
Mailing Address - Street 2:ST #100
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36609-6589
Mailing Address - Country:US
Mailing Address - Phone:251-476-5555
Mailing Address - Fax:251-970-3390
Practice Address - Street 1:3500 COTTAGE HILL RD
Practice Address - Street 2:ST #100
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36609-6589
Practice Address - Country:US
Practice Address - Phone:251-476-5555
Practice Address - Fax:251-970-3390
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-15
Last Update Date:2010-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009967030Medicaid
AL009967030Medicaid