Provider Demographics
NPI:1457326415
Name:HEALTHGROUP OF ALABAMA, LLC
Entity Type:Organization
Organization Name:HEALTHGROUP OF ALABAMA, LLC
Other - Org Name:HOME HEALTH GROUP - DECATUR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:E
Authorized Official - Last Name:DOTSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-922-6680
Mailing Address - Street 1:6767 OLD MADISON PIKE
Mailing Address - Street 2:STE 400
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35806
Mailing Address - Country:US
Mailing Address - Phone:256-922-6650
Mailing Address - Fax:256-922-6651
Practice Address - Street 1:1323 STRATFORD RD
Practice Address - Street 2:SUITE B
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601
Practice Address - Country:US
Practice Address - Phone:256-350-4182
Practice Address - Fax:256-309-5908
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-22
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS04924314Medicaid
5753137OtherAETNA
AL51516749OtherBLUE CROSS BLUE SHIELD
ALHEL7027AMedicaid
AL51516749OtherBLUE CROSS BLUE SHIELD