Provider Demographics
NPI:1699831529
Name:P.H.S. OF ALABAMA LLC
Entity Type:Organization
Organization Name:P.H.S. OF ALABAMA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:P
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:256-927-7408
Mailing Address - Street 1:230 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CENTRE
Mailing Address - State:AL
Mailing Address - Zip Code:35960-1326
Mailing Address - Country:US
Mailing Address - Phone:256-927-7408
Mailing Address - Fax:256-927-7444
Practice Address - Street 1:230 W MAIN ST
Practice Address - Street 2:
Practice Address - City:CENTRE
Practice Address - State:AL
Practice Address - Zip Code:35960-1326
Practice Address - Country:US
Practice Address - Phone:256-927-7408
Practice Address - Fax:256-927-7444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51020251515086OtherBLUE CROSS BLUE SHIELD
AL4525700001Medicare NSC