Provider Demographics
NPI:1902150766
Name:COOSA VALLEY RESPIRATORY & HOME MEDICAL, INC.
Entity type:Organization
Organization Name:COOSA VALLEY RESPIRATORY & HOME MEDICAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:M
Authorized Official - Last Name:FRANKLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-221-8268
Mailing Address - Street 1:7044 ATLANTA HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117
Mailing Address - Country:US
Mailing Address - Phone:334-272-2729
Mailing Address - Fax:334-272-2705
Practice Address - Street 1:7044 ATLANTA HWY
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117
Practice Address - Country:US
Practice Address - Phone:334-272-2729
Practice Address - Fax:334-272-2705
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MED SOUTH, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-11-01
Last Update Date:2012-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332BP3500X, 332B00000X
AL900567332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies