Provider Demographics
NPI:1215287651
Name:BROOKWOOD HOME HEALTH LLC
Entity type:Organization
Organization Name:BROOKWOOD HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGIONAL CFO, TENET
Authorized Official - Prefix:MR
Authorized Official - First Name:WESLEY
Authorized Official - Middle Name:O
Authorized Official - Last Name:JAMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-265-5009
Mailing Address - Street 1:1445 ROSS AVE
Mailing Address - Street 2:SUITE 1400
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75202
Mailing Address - Country:US
Mailing Address - Phone:469-893-2000
Mailing Address - Fax:
Practice Address - Street 1:801 PRINCETON AVE SW STE 210
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35211-1334
Practice Address - Country:US
Practice Address - Phone:205-949-5510
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-13
Last Update Date:2017-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
017175Medicare PIN