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Contact Information

ATHENS CONVALESCENT CENTER
611 W MARKET ST
ATHENS, AL35611-2460
 Phone: 256-232-1620
 Fax: 256-232-2017
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Skilled Nursing Facility

314000000X A1[8] Skilled Nursing Facility
 

Parenteral & Enteral Nutrition

332BP3500X 87 All Other Suppliers
Indicates primary specialty

NPI Profile & details for ATHENS CONVALESCENT CENTER

NPI # 1386631521
LBN Legal business name ATHENS CONVALESCENT CENTER
Authorized official JOHN WALLACE - (ADMINISTRATOR)
Entity Organization
Organization subpart 1 No
Enumeration date 10/03/2005
Last updated 10/14/2009 - About 17 years ago
Identifiers
AL License # 54038
AL License # N4201
AL Medicaid 4757080S
AL Other 015016 MEDICARE PART A PROVIDER
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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