Organization
P.H.S. OF ALABAMA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES P. WALKER JR. (OWNER)
(256) 927-7408
Entity
Organization
Contact information
Practice address
230 W MAIN ST, CENTRE, AL 35960-1326
(256) 927-7408
(256) 927-7444
Mailing address
230 W MAIN ST, CENTRE, AL 35960-1326
(256) 927-7408
(256) 927-7444
Taxonomy
Speciality
Code
Description
License number
State
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51020251515086
BLUE CROSS BLUE SHIELD
AL
Enumeration date
12/28/2006
Last updated
08/22/2020
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