Provider Demographics
NPI:1538111893
Name:ATMORE COMMUNITY HOME CARE, LLC
Entity Type:Organization
Organization Name:ATMORE COMMUNITY HOME CARE, LLC
Other - Org Name:ATMORE COMMUNITY HOME CARE, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:FITZPATRICK
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:251-368-6286
Mailing Address - Street 1:121-C LINDBERG AVENUE
Mailing Address - Street 2:
Mailing Address - City:ATMORE
Mailing Address - State:AL
Mailing Address - Zip Code:36502
Mailing Address - Country:US
Mailing Address - Phone:251-368-6286
Mailing Address - Fax:251-368-6289
Practice Address - Street 1:121-C LINDBERG AVENUE
Practice Address - Street 2:
Practice Address - City:ATMORE
Practice Address - State:AL
Practice Address - Zip Code:36502
Practice Address - Country:US
Practice Address - Phone:251-368-6286
Practice Address - Fax:251-368-6289
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ESCAMBIA COUNTY ALABAMA COMMUNITY HOSPITALS, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-16
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALATM7412AMedicaid
AL011454OtherBCBS OF ALABAMA
AL011454OtherBCBS OF ALABAMA