Provider Demographics
NPI:1558411777
Name:PEOPLES HOME CARE LLC
Entity Type:Organization
Organization Name:PEOPLES HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:CHESTEEN
Authorized Official - Last Name:WIX
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:256-359-6242
Mailing Address - Street 1:8260 HWY 72W
Mailing Address - Street 2:
Mailing Address - City:CHEROKEE
Mailing Address - State:AL
Mailing Address - Zip Code:35616
Mailing Address - Country:US
Mailing Address - Phone:256-359-6242
Mailing Address - Fax:256-359-4652
Practice Address - Street 1:8260 HIGHWAY 72
Practice Address - Street 2:
Practice Address - City:CHEROKEE
Practice Address - State:AL
Practice Address - Zip Code:35616-4402
Practice Address - Country:US
Practice Address - Phone:256-359-6242
Practice Address - Fax:256-359-4652
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-11
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL106760332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL5668200001Medicare NSC