Provider Demographics
NPI:1861675027
Name:NEW BEACON HEALTHCARE GROUP, LLC
Entity Type:Organization
Organization Name:NEW BEACON HEALTHCARE GROUP, LLC
Other - Org Name:NEW BEACON OF ANDALUSIA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO AND PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:E
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-939-8711
Mailing Address - Street 1:2151 HIGHLAND AVE S
Mailing Address - Street 2:SUITE 350
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205-4079
Mailing Address - Country:US
Mailing Address - Phone:205-939-8711
Mailing Address - Fax:205-939-8778
Practice Address - Street 1:513 E THREE NOTCH ST STE D
Practice Address - Street 2:
Practice Address - City:ANDALUSIA
Practice Address - State:AL
Practice Address - Zip Code:36420-3164
Practice Address - Country:US
Practice Address - Phone:205-939-8711
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-11
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALAPPLIED FOR251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based