Provider Demographics
NPI:1437220456
Name:ADORATION HOSPICE CARE ALABAMA, LLC
Entity Type:Organization
Organization Name:ADORATION HOSPICE CARE ALABAMA, LLC
Other - Org Name:HOSPICE SERVICES OF ALABAMA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER PROVIDER ENROLLMENT
Authorized Official - Prefix:
Authorized Official - First Name:ANGIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MATTINGLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-381-3579
Mailing Address - Street 1:1000 SOUTHLAKE PARK STE 100
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35244-5700
Mailing Address - Country:US
Mailing Address - Phone:205-682-9996
Mailing Address - Fax:205-682-9994
Practice Address - Street 1:1631 HAMRIC DR E
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:AL
Practice Address - Zip Code:36203-2035
Practice Address - Country:US
Practice Address - Phone:205-682-9996
Practice Address - Fax:205-682-9994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL11683251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALPIC1629EMedicaid
AL012537OtherBLUE CROSS BLUE SHIELD
AL011629Medicare Oscar/Certification