Provider Demographics
NPI:1780681452
Name:SECURE HEALTH SYSTEMS
Entity Type:Organization
Organization Name:SECURE HEALTH SYSTEMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:KEN
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:POGUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-270-1342
Mailing Address - Street 1:974 PLANTATION WAY
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-2286
Mailing Address - Country:US
Mailing Address - Phone:334-270-1342
Mailing Address - Fax:334-270-4236
Practice Address - Street 1:974 PLANTATION WAY
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-2286
Practice Address - Country:US
Practice Address - Phone:334-270-1342
Practice Address - Fax:334-270-4236
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Not Answered332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1127720001Medicare ID - Type UnspecifiedHME