Provider Demographics
NPI:1699845255
Name:AZALEA HEALTH CARE, INC.
Entity Type:Organization
Organization Name:AZALEA HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DEXTER
Authorized Official - Middle Name:
Authorized Official - Last Name:JULIEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-344-9443
Mailing Address - Street 1:805 S. CHURCH ST.
Mailing Address - Street 2:SUITE B
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36602-1112
Mailing Address - Country:US
Mailing Address - Phone:251-344-9443
Mailing Address - Fax:251-344-9880
Practice Address - Street 1:805 S. CHURCH ST.
Practice Address - Street 2:SUITE B
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36602-1112
Practice Address - Country:US
Practice Address - Phone:251-344-9443
Practice Address - Fax:251-344-9880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-09
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL577332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL0447180001Medicare NSC