Provider Demographics
NPI:1275569873
Name:BALL HEALTHCARE EASTVIEW INC
Entity Type:Organization
Organization Name:BALL HEALTHCARE EASTVIEW INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SARA
Authorized Official - Middle Name:L
Authorized Official - Last Name:WALLACE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-833-0146
Mailing Address - Street 1:1 SOUTHERN WAY
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36619-1210
Mailing Address - Country:US
Mailing Address - Phone:251-433-9801
Mailing Address - Fax:251-433-9807
Practice Address - Street 1:7755 4TH AVE S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35206-4425
Practice Address - Country:US
Practice Address - Phone:205-833-0146
Practice Address - Fax:205-833-2978
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-24
Last Update Date:2016-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL12569314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL4750140SMedicaid
AL4750140SMedicaid
015014Medicare Oscar/Certification