Provider Demographics
NPI: | 1366638058 |
---|---|
Name: | HC HEALTHCARE, LLC |
Entity Type: | Organization |
Organization Name: | HC HEALTHCARE, LLC |
Other - Org Name: | HC HEALTHCARE, INC |
Other - Org Type: | Former Legal Business Name |
Authorized Official - Title/Position: | COO |
Authorized Official - Prefix: | |
Authorized Official - First Name: | KAYANNE |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | MYNSBERGE |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 989-891-2210 |
Mailing Address - Street 1: | 2153 RIVERCHASE OFFICE RD |
Mailing Address - Street 2: | |
Mailing Address - City: | BIRMINGHAM |
Mailing Address - State: | AL |
Mailing Address - Zip Code: | 35244-1836 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 205-988-8669 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 4150 CARMICHAEL CT |
Practice Address - Street 2: | |
Practice Address - City: | MONTGOMERY |
Practice Address - State: | AL |
Practice Address - Zip Code: | 36106-2871 |
Practice Address - Country: | US |
Practice Address - Phone: | 334-270-2274 |
Practice Address - Fax: | 334-270-2275 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2007-09-17 |
Last Update Date: | 2013-01-16 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 251G00000X | Agencies | Hospice Care, Community Based |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
AL | E5111 | Other | STATE |