Provider Demographics
NPI:1609389337
Name:HEATH HEALTH AND WELLNESS
Entity Type:Organization
Organization Name:HEATH HEALTH AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:SUSANNE
Authorized Official - Last Name:HEATH
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:205-401-0976
Mailing Address - Street 1:24750 STATE ST UNIT 695
Mailing Address - Street 2:
Mailing Address - City:ELBERTA
Mailing Address - State:AL
Mailing Address - Zip Code:36530-2024
Mailing Address - Country:US
Mailing Address - Phone:205-401-0976
Mailing Address - Fax:
Practice Address - Street 1:9275 BAY POINT DR
Practice Address - Street 2:
Practice Address - City:ELBERTA
Practice Address - State:AL
Practice Address - Zip Code:36530-6561
Practice Address - Country:US
Practice Address - Phone:205-401-0976
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-16
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care