Provider Demographics
NPI:1063529121
Name:ST. VINCENT'S HOME HEALTH, LLC
Entity type:Organization
Organization Name:ST. VINCENT'S HOME HEALTH, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:JERNIGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-313-2800
Mailing Address - Street 1:1400 URBAN CENTER DR
Mailing Address - Street 2:SUITE 240
Mailing Address - City:VESTAVIA
Mailing Address - State:AL
Mailing Address - Zip Code:35242-2580
Mailing Address - Country:US
Mailing Address - Phone:205-313-2800
Mailing Address - Fax:205-313-2801
Practice Address - Street 1:1400 URBAN CENTER DR
Practice Address - Street 2:SUITE 240
Practice Address - City:VESTAVIA
Practice Address - State:AL
Practice Address - Zip Code:35242-2580
Practice Address - Country:US
Practice Address - Phone:205-313-2800
Practice Address - Fax:205-313-2801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-24
Last Update Date:2011-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL017033Medicare ID - Type UnspecifiedMEDICARE #