Provider Demographics
NPI:1164468377
Name:ATHENS LIMESTONE HEALTH SERVICES, LLC
Entity Type:Organization
Organization Name:ATHENS LIMESTONE HEALTH SERVICES, LLC
Other - Org Name:ATHENS LIMESTONE HOSPITAL HOME HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:B
Authorized Official - Last Name:TATE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-233-9533
Mailing Address - Street 1:661 US HIGHWAY 72 W
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:AL
Mailing Address - Zip Code:35611-4211
Mailing Address - Country:US
Mailing Address - Phone:256-233-9533
Mailing Address - Fax:256-233-9535
Practice Address - Street 1:661 US HIGHWAY 72 W
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:AL
Practice Address - Zip Code:35611-4211
Practice Address - Country:US
Practice Address - Phone:256-233-9533
Practice Address - Fax:256-233-9535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALATH7095AMedicaid
ALATH7095AMedicaid