Organization
RIDGEVIEW HEALTH SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JOETTE KELLEY-BROWN LNHA (OWNER/ADMINISTRATOR)
(205) 221-9111
Entity
Organization
Contact information
Practice address
907 11TH ST NE, JASPER, AL 35504-8821
(205) 221-9111
(205) 387-1912
Mailing address
903 11TH ST NE, JASPER, AL 35504-8821
(205) 221-9111
(205) 387-1912
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
12697
AL
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
N6401
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010685
BLUE CROSS PROVIDER NUMBE
AL
01
—
40232
HEALTHSPRINGS PROVIDER NU
AL
05
—
4753280S
—
AL
Enumeration date
09/11/2006
Last updated
03/28/2012
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