Provider Demographics
NPI:1508222530
Name:MEADOWS HEALTHCARE ALLIANCE
Entity Type:Organization
Organization Name:MEADOWS HEALTHCARE ALLIANCE
Other - Org Name:ALLIANCE HOME MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:R
Authorized Official - Last Name:CORNELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-537-6930
Mailing Address - Street 1:1180 RIBAUT RD
Mailing Address - Street 2:UNIT 1 & 2
Mailing Address - City:BEAUFORT
Mailing Address - State:SC
Mailing Address - Zip Code:29902-6108
Mailing Address - Country:US
Mailing Address - Phone:843-379-1011
Mailing Address - Fax:843-379-1012
Practice Address - Street 1:1180 RIBAUT RD
Practice Address - Street 2:UNIT 1 & 2
Practice Address - City:BEAUFORT
Practice Address - State:SC
Practice Address - Zip Code:29902-6108
Practice Address - Country:US
Practice Address - Phone:843-379-1011
Practice Address - Fax:843-379-1012
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MEADOWS REGIONAL HOME CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-01-06
Last Update Date:2016-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC214682015332B00000X, 332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies