Coosa Valley Respiratory & Home Medical, Inc.

Primary specialty

Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X

License

634 Issued in AL

Legal business name

COOSA VALLEY RESPIRATORY & HOME MEDICAL, INC.

Practice address

201 W. Ft. Williams St.
Ste. 28
Sylacauga, AL 35150-2468

Phone

(256) 245-1411

Fax

(256) 245-1471

NPI assigned

May 9, 2006

Organization subpart

No

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

Authorized official

Name

Lisa J. Wells Jr., CPCO

Title

Executive Director

Phone

(205) 221-8258

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Med South, Inc.

  • Oxygen Equipment & Supplies (DME)
  • Huntsville, AL
  • NPI 1528495843

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573516800000",
    "number": "1750330361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 MEDICAL CENTER DR.",
            "city": "JASPER",
            "state": "AL",
            "postal_code": "355013400",
            "telephone_number": "205-221-8200",
            "fax_number": "205-221-8270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 W. FT. WILLIAMS ST.",
            "address_2": "STE. 28",
            "city": "SYLACAUGA",
            "state": "AL",
            "postal_code": "351502468",
            "telephone_number": "256-245-1411",
            "fax_number": "256-245-1471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COOSA VALLEY RESPIRATORY & HOME MEDICAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-09",
        "last_updated": "2019-11-12",
        "status": "A",
        "authorized_official_last_name": "WELLS",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "205-221-8258",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "CPCO"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "AL",
            "license": "634",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009932266",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Coosa Valley Chiropractic Center,Inc.
• Coosa Valley Healthcare Center LLC
• Coosa Valley Hearing Clinic, Inc
• Coosa Valley Homecare, LLC (Adoration Home Health)
• Coosa Valley Pediatrics
• Coosa Valley Sports Medicine and Primary Care LLC
• Coosa Valley Surgical Associates
• Coosa Valley Urology, P.C.
• Yvonne Price Copeland, LICSW
• Craddock Health Center P C

• Oxygen Equipment & Supplies (DME) in Sylacauga, AL
• Providers in Sylacauga, AL by specialty
• Oxygen Equipment & Supplies (DME) in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.