| NPI Details | |
|---|---|
| NPI | 1225211709 |
| Enumeration Date | 12/07/2007 |
| Last Updated | 01/17/2012 |
| Entity Type | Healthcare Provider |
| Active | Over 9 years ago |
| Authorized Information | |
|---|---|
| Name | PAM PAM |
| Position | HOME HEALTH DIRECTOR |
| Phone | (256) 825-7050 |
| Fax | (256) 825-7068 |
| Practice Location | |
|---|---|
| 301 MARIARDEN RD SUITE F DADEVILLE AL, 36853-6254, US |
|
| Phone | (256) 825-7050 |
| Fax | (256) 825-7068 |
| Business Location | |
|---|---|
| 301 MARIARDEN RD SUITE F DADEVILLE AL, 36853-6254, US |
|
| Phone | (256) 825-7050 |
| Fax | (256) 825-7068 |
| Toxanomy | |
|---|---|
| Taxonomy Code | 251E00000X |
| License State | Alabama |
| License Number | 017117 |
| Remove 1225211709 NPI Number | |
According to our database, Ivy Creek Of Tallapoosa Llc NPI is 1225211709, taxonomy code is 251E00000X and license number is 017117, license state is located at Alabama. Ivy Creek Of Tallapoosa Llc physically located at 301 Mariarden Rd, Dadeville AL, 36853-6254. NPI Number 1033115704 has the healthcare provider type.
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1225211709 NPI number is provided on an as is basis without warranty of any kind. 1225211709 is maintained by the National Plan & Provider Enumeration System. The contents of Ivy Creek Of Tallapoosa Llc are for informational purposes only.
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