Organization
VAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JENNIE MELISSA TEDDER (BOOKKEEPER)
(205) 491-2411
Entity
Organization
Contact information
Practice address
131 E CREST RD, HUEYTOWN, AL 35023-1623
(205) 491-2411
(205) 491-8750
Mailing address
131 E CREST RD, HUEYTOWN, AL 35023-1623
(205) 491-2411
(205) 491-8750
Taxonomy
Speciality
Code
Description
License number
State
332BN1400X
Nursing Facility Supplies (DME)
Primary
320133776
AL
Other
Enumeration date
05/07/2008
Last updated
05/07/2008
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