Coosa Nursing Adk, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

12535 Issued in AL

Legal business name

COOSA NURSING ADK, LLC

Doing business as

Coosa Valley Health Care

Practice address

513 Pineview Ave
Glencoe, AL 35905-1803

Phone

(256) 492-5350

NPI assigned

Oct 3, 2006

Last updated

Feb 3, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Carol Groeber

Title

Vice President/Mis

Phone

(937) 964-8974

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• COOSA VALLEY HEALTH CARE Doing business as

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296691200000",
    "number": "1861586737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "513 PINEVIEW AVE",
            "city": "GLENCOE",
            "state": "AL",
            "postal_code": "359051803",
            "telephone_number": "256-492-5350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "513 PINEVIEW AVE",
            "city": "GLENCOE",
            "state": "AL",
            "postal_code": "359051803",
            "telephone_number": "256-492-5350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COOSA NURSING ADK, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2011-02-03",
        "status": "A",
        "authorized_official_last_name": "GROEBER",
        "authorized_official_first_name": "CAROL",
        "authorized_official_title_or_position": "VICE PRESIDENT/MIS",
        "authorized_official_telephone_number": "937-964-8974"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "AL",
            "license": "12535",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4753160S",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COOSA VALLEY HEALTH CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• C.R. of Coosa Valley, LLC (Coosa Valley Health and Rehab)
• Coosa Valley SNF Operations LLC
• Carol Sue Costner, ALC
• Glencoe Family Chiropractic, LLC
• Mary Kristin Hale, D.C.
• J & a Pharmacy of Glencoe Inc. (Alaco Discount Pharmacy)

• Skilled Nursing Facility in Glencoe, AL
• Providers in Glencoe, AL by specialty
• Skilled Nursing Facility in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2011; 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.