Provider Demographics
NPI:1376009118
Name:MEADOWS HEALTHCARE ALLIANCE, INC.
Entity Type:Organization
Organization Name:MEADOWS HEALTHCARE ALLIANCE, INC.
Other - Org Name:ALLIANCE HOME MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AVP POST ACUTE CARE
Authorized Official - Prefix:
Authorized Official - First Name:JOHNNY
Authorized Official - Middle Name:
Authorized Official - Last Name:CARROLL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-537-6930
Mailing Address - Street 1:1525 FAIR RD STE 105
Mailing Address - Street 2:
Mailing Address - City:STATESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30458-6118
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1525 FAIR RD STE 105
Practice Address - Street 2:
Practice Address - City:STATESBORO
Practice Address - State:GA
Practice Address - Zip Code:30458-6118
Practice Address - Country:US
Practice Address - Phone:912-243-9103
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MEADOWS REGIONAL MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-02-18
Last Update Date:2019-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies