Hideaway Health Table LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

HIDEAWAY HEALTH TABLE LLC

Doing business as

Hideaway Health

Practice address

4817 Brownston CT SE
Owens Cross Roads, AL 35763-9161

Phone

(256) 426-3593

NPI assigned

Apr 24, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Gregory Gilliland, PTA

Title

Owner

Phone

(256) 426-3593

Specialties & licenses 1

Addresses

Other names 1

• Hideaway Health Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1556064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556064000000",
    "number": "1043874068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4817 BROWNSTON CT SE",
            "city": "OWENS CROSS ROADS",
            "state": "AL",
            "postal_code": "357639161",
            "telephone_number": "256-426-3593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4817 BROWNSTON CT SE",
            "city": "OWENS CROSS ROADS",
            "state": "AL",
            "postal_code": "357639161",
            "telephone_number": "256-426-3593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIDEAWAY HEALTH TABLE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-24",
        "last_updated": "2019-04-24",
        "status": "A",
        "authorized_official_last_name": "GILLILAND",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "256-426-3593",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PTA"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hideaway Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Durable Medical Equipment & Medical Supplies in Owens Cross Roads, AL
• Providers in Owens Cross Roads, AL by specialty
• Durable Medical Equipment & Medical Supplies in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.