Provider Demographics
NPI:1124265525
Name:COLE-MEDICAL
Entity type:Organization
Organization Name:COLE-MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:COLE
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:205-951-9514
Mailing Address - Street 1:208 MOSS ROCK LN
Mailing Address - Street 2:
Mailing Address - City:IRONDALE
Mailing Address - State:AL
Mailing Address - Zip Code:35210-1721
Mailing Address - Country:US
Mailing Address - Phone:205-951-9514
Mailing Address - Fax:
Practice Address - Street 1:208 MOSS ROCK LN
Practice Address - Street 2:
Practice Address - City:IRONDALE
Practice Address - State:AL
Practice Address - Zip Code:35210-1721
Practice Address - Country:US
Practice Address - Phone:205-951-9514
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-07
Last Update Date:2009-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies