Organization
MANOR CARE HEALTH SERVICES INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PHILLIP RANDAL WADE (PRES.)
(256) 332-1810
Entity
Organization
Contact information
Practice address
390 UNDERWOOD RD, RUSSELLVILLE, AL 35653-4105
(256) 332-1810
(256) 332-3874
Mailing address
390 UNDERWOOD RD, RUSSELLVILLE, AL 35653-4105
(256) 332-1810
(256) 332-3874
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
EXEMPT
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0667040001
DME MAC
AL
Enumeration date
10/06/2006
Last updated
02/07/2008
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