Provider Demographics
NPI:1225111230
Name:SOUTHERN ELEVATOR SERVICE, INC.
Entity Type:Organization
Organization Name:SOUTHERN ELEVATOR SERVICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:H
Authorized Official - Last Name:STAGG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-830-6976
Mailing Address - Street 1:116 CASTLE DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-8674
Mailing Address - Country:US
Mailing Address - Phone:256-830-6976
Mailing Address - Fax:256-430-0858
Practice Address - Street 1:116 CASTLE DR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-8674
Practice Address - Country:US
Practice Address - Phone:256-830-6976
Practice Address - Fax:256-430-0858
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL271332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies