Organization
NORTHGATE HME HLTH CRE IN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT L EDWARDS RPH (PRESIDENT)
(256) 767-2273
Entity
Organization
Contact information
Practice address
3522 CLOVERDALE RD, FLORENCE, AL 35633-1339
(256) 767-2273
(256) 767-2273
Mailing address
3522 CLOVERDALE RD, FLORENCE, AL 35633-1339
(256) 767-2273
(256) 767-2273
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
277
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3558427
—
TN
01
—
56514
BLUE CROSS
AL
Enumeration date
11/02/2006
Last updated
04/20/2008
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