Provider Demographics
NPI:1609214568
Name:MEADOWS HEALTHCARE ALLIANCE, INC.
Entity Type:Organization
Organization Name:MEADOWS HEALTHCARE ALLIANCE, INC.
Other - Org Name:ALLIANCE HOME MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF OPERATION AND MARKETING
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHNNY
Authorized Official - Middle Name:
Authorized Official - Last Name:CARROLL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-537-6930
Mailing Address - Street 1:709 STEPHENSON AVE
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-5971
Mailing Address - Country:US
Mailing Address - Phone:912-200-3346
Mailing Address - Fax:912-200-3453
Practice Address - Street 1:709 STEPHENSON AVE
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-5971
Practice Address - Country:US
Practice Address - Phone:912-200-3346
Practice Address - Fax:912-200-3453
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MEADOWS REGIONAL HOME CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-06-12
Last Update Date:2014-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAGBU20130020332B00000X, 332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies