Provider Demographics
NPI:1457796914
Name:MOBILE NURSING OPERATIONS, LLC
Entity Type:Organization
Organization Name:MOBILE NURSING OPERATIONS, LLC
Other - Org Name:AZALEA GARDENS OF MOBILE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JACK
Authorized Official - Middle Name:H
Authorized Official - Last Name:SANDERS
Authorized Official - Suffix:
Authorized Official - Credentials:NFA
Authorized Official - Phone:318-590-0007
Mailing Address - Street 1:145 N HIGHLAND DR
Mailing Address - Street 2:
Mailing Address - City:MANY
Mailing Address - State:LA
Mailing Address - Zip Code:71449-3715
Mailing Address - Country:US
Mailing Address - Phone:318-590-0007
Mailing Address - Fax:318-590-1711
Practice Address - Street 1:1758 SPRING HILL AVE
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36607-3508
Practice Address - Country:US
Practice Address - Phone:251-479-0551
Practice Address - Fax:251-479-1732
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-09
Last Update Date:2014-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL015151Medicare Oscar/Certification