Provider Demographics
NPI:1851420426
Name:NEWMAN'S HEALTHCARE SERVICES, LLC.
Entity Type:Organization
Organization Name:NEWMAN'S HEALTHCARE SERVICES, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JEALEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DANTZLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-473-1884
Mailing Address - Street 1:2601 GOVERNMENT BLVD
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36606-2601
Mailing Address - Country:US
Mailing Address - Phone:251-473-1884
Mailing Address - Fax:251-473-1848
Practice Address - Street 1:2601 GOVERNMENT BLVD
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36606-2601
Practice Address - Country:US
Practice Address - Phone:251-473-1884
Practice Address - Fax:251-473-1848
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-02
Last Update Date:2007-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL011404332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL5883660001Medicare NSC