Provider Demographics
NPI:1013326347
Name:MBRL
Entity Type:Organization
Organization Name:MBRL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:D
Authorized Official - Last Name:HERBERT
Authorized Official - Suffix:JR
Authorized Official - Credentials:PHD
Authorized Official - Phone:256-763-0855
Mailing Address - Street 1:PO BOX 2988
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35202-3806
Mailing Address - Country:US
Mailing Address - Phone:256-763-0855
Mailing Address - Fax:256-217-9338
Practice Address - Street 1:600 BOULEVARD SOUTH SW
Practice Address - Street 2:SUITE #104
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35802-2113
Practice Address - Country:US
Practice Address - Phone:256-763-0855
Practice Address - Fax:256-217-9338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-12
Last Update Date:2014-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1816253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care