Provider Demographics
NPI:1851349823
Name:ELROD SALES AND SERVICE INC
Entity Type:Organization
Organization Name:ELROD SALES AND SERVICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:ELROD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-424-5858
Mailing Address - Street 1:1930 3RD AVE N
Mailing Address - Street 2:
Mailing Address - City:BESSEMER
Mailing Address - State:AL
Mailing Address - Zip Code:35020-4910
Mailing Address - Country:US
Mailing Address - Phone:205-424-5858
Mailing Address - Fax:205-424-5883
Practice Address - Street 1:1930 3RD AVE N
Practice Address - Street 2:
Practice Address - City:BESSEMER
Practice Address - State:AL
Practice Address - Zip Code:35020-4910
Practice Address - Country:US
Practice Address - Phone:205-424-5858
Practice Address - Fax:205-424-5883
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-04
Last Update Date:2013-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL107332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA51057198OtherBLUE CROSS BLUE SHIELD AL
LA00057198Medicaid
LA51057198OtherBLUE CROSS BLUE SHIELD AL