Centrad Healthcare LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

613 Issued in AL

Legal business name

CENTRAD HEALTHCARE LLC

Practice address

2712 7TH Ave S
Birmingham, AL 35233-3406

Phone

(205) 380-3113

Fax

(205) 380-3116

NPI assigned

Dec 4, 2006

Organization subpart

No

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

Authorized official

Name

Gidgett Ann Callaghan

Title

VP, Reimbursement

Phone

(630) 369-5840

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239062400000",
    "number": "1285702407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "184 SHUMAN BLVD",
            "address_2": "SUITE 130",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605631219",
            "telephone_number": "630-369-5840",
            "fax_number": "630-369-5436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2712 7TH AVE S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352333406",
            "telephone_number": "205-380-3113",
            "fax_number": "205-380-3116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAD HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-04",
        "last_updated": "2009-04-07",
        "status": "A",
        "authorized_official_last_name": "CALLAGHAN",
        "authorized_official_first_name": "GIDGETT",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "VP, REIMBURSEMENT",
        "authorized_official_telephone_number": "630-369-5840"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "AL",
            "license": "613",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009959640",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009974810",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Birmingham, AL
• 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 7, 2009; 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.