Provider Demographics
NPI:1194164491
Name:SMITH HEALTHCARE SERVICE LLC
Entity type:Organization
Organization Name:SMITH HEALTHCARE SERVICE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:COLLEEN
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-554-3238
Mailing Address - Street 1:442 COTTAGE HILL RD
Mailing Address - Street 2:APT A101
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36606-4726
Mailing Address - Country:US
Mailing Address - Phone:251-552-3238
Mailing Address - Fax:
Practice Address - Street 1:442 COTTAGE HILL RD
Practice Address - Street 2:APT A101
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36606-4726
Practice Address - Country:US
Practice Address - Phone:251-554-3238
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-19
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
AL251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based