Provider Demographics
NPI:1578136305
Name:PERSONAL CARE AGENCY
Entity Type:Organization
Organization Name:PERSONAL CARE AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:HAWKINS
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:205-765-7937
Mailing Address - Street 1:2110 MCFARLAND BLVD E STE B
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35404-5820
Mailing Address - Country:US
Mailing Address - Phone:205-765-7937
Mailing Address - Fax:205-737-7989
Practice Address - Street 1:2110 MCFARLAND BLVD E STE B
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35404-5820
Practice Address - Country:US
Practice Address - Phone:205-765-7937
Practice Address - Fax:205-737-7989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-20
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care