; NPI #1205439841

Contact Information

EDNECIA FITZPATRICK

6107 BROADWING RD
TRUSSVILLE, AL 35173-6314

Phone: 404-442-5001
Fax:
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Respite Care	385H00000X
Driver	172A00000X
Home Health	251E00000X	A4[11]	Home Health Agency
Mental Health (Including Community Mental Health Center)	261QM0801X	B4[14]	Community Mental Health Center
Non-emergency Medical Transport (VAN)	343900000X
Nursing Home Administrator	376G00000X

Indicates primary specialty

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NPI Profile & details for

NPI # 1205439841

Entity Organization

Organization subpart ¹ Not specified

Enumeration date 11/17/2020

Last updated 11/17/2020 - About 6 years ago

Identifiers

Medicaid

85-1764905

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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