Organization
SUNBRIDGE HEALTHCARE LLC
Active
Other names
Cottage of the Shoals
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL T. BERG (ASSISTANT SECRETARY)
(505) 468-4752
Entity
Organization
Contact information
Practice address
500 JOHN ALDRIDGE DR, TUSCUMBIA, AL 35674-3000
(256) 383-4541
(256) 383-2966
Mailing address
500 JOHN ALDRIDGE DR, TUSCUMBIA, AL 35674-3000
(256) 383-4541
(256) 383-2966
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
16644
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010-676
BC/BS OF AL & BC/BS OF TN
AL
01
—
392722
HIGHMARK BLUE SHIELD
—
05
—
4757720S
—
AL
01
—
71-00083
UNITED HEALTHCARE OF ALA
AL
Enumeration date
05/13/2006
Last updated
03/30/2017
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