Provider Demographics
NPI:1205502929
Name:MENDING HEARTS ON WHEELS
Entity type:Organization
Organization Name:MENDING HEARTS ON WHEELS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EARNESTINE
Authorized Official - Middle Name:POLLARD
Authorized Official - Last Name:ALEXANDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-462-8931
Mailing Address - Street 1:3477 CROSS CREEK DR
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36116-3654
Mailing Address - Country:US
Mailing Address - Phone:334-462-8931
Mailing Address - Fax:334-281-9052
Practice Address - Street 1:3477 CROSS CREEK DR
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36116-3654
Practice Address - Country:US
Practice Address - Phone:334-462-8931
Practice Address - Fax:334-281-9052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-22
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health