Provider Demographics
NPI:1568565075
Name:OAK RIDGE HEALTH SYSTEMS, INC.
Entity Type:Organization
Organization Name:OAK RIDGE HEALTH SYSTEMS, INC.
Other - Org Name:OAK RIDGE HOME MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:D.
Authorized Official - Middle Name:GREG
Authorized Official - Last Name:MOORER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-666-0891
Mailing Address - Street 1:4180A OAK RIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36619-1851
Mailing Address - Country:US
Mailing Address - Phone:251-666-0891
Mailing Address - Fax:251-661-0483
Practice Address - Street 1:4180A OAK RIDGE AVE
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36619-1851
Practice Address - Country:US
Practice Address - Phone:251-666-0891
Practice Address - Fax:251-661-0483
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-07
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL112024332B00000X, 332BC3200X, 332BP3500X, 332BX2000X, 333600000X, 3336C0003X, 3336H0001X, 3336M0002X, 3336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No3336M0002XSuppliersPharmacyMail Order Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL510-54421OtherDME
MS00440451Medicaid
AL510-44136OtherNURSING
AL100001190Medicaid
366190001OtherCSP
AL1568565075Medicaid
AL009309140Medicaid
AL009309140Medicaid
MS00440451Medicaid
AL100001190Medicaid