Provider Demographics
NPI:1487647210
Name:THERA CONNECTION INC
Entity Type:Organization
Organization Name:THERA CONNECTION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:FRANCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-802-2275
Mailing Address - Street 1:3351 INDEPENDENCE DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-9000
Mailing Address - Country:US
Mailing Address - Phone:205-802-2275
Mailing Address - Fax:205-278-6919
Practice Address - Street 1:3351 INDEPENDENCE DR
Practice Address - Street 2:SUITE 101
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-9000
Practice Address - Country:US
Practice Address - Phone:205-802-2275
Practice Address - Fax:205-278-6919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-26
Last Update Date:2014-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL362332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1321000001Medicare NSC