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Organization

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Active
Organization subpart
No

Provider details

NPI number
Authorized official
MARY HIX (OWNER)
(256) 878-0105
Entity
Organization

Contact information

Practice address
119 SAND MOUNTAIN DR NE, ALBERTVILLE, AL 35950-1709
(256) 878-0105
Mailing address
119 SAND MOUNTAIN DR NE, ALBERTVILLE, AL 35950-1709
(256) 878-0105

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
51057700
BCBS AL
AL
Enumeration date
03/30/2007
Last updated
07/16/2007
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