| Name: | Birmingham Home Infusion LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Limited Liability Company |
| Status: | Exists |
| Date of registration: | 23 Apr 2015 (10 years ago) |
| Entity Number: | 000-336-605 |
| Register Number: | 000336605 |
| County: | Jefferson |
| Place of Formation: | Jefferson County |
| Registered Office Street Address: | 625 FOUNDERS PARK DRIVE WESTHOOVER, AL 35226 |
| Registered Office Street Address ZIP Code: | 35226 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 1134502727 | 2015-07-01 | 2019-10-21 | 300 AIRPORT COMMONS DRIVE, SUITE 304, CALERA, AL, 35040, US | 300 AIRPORT COMMONS DRIVE, SUITE 304, CALERA, AL, 35040, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 205-605-7633 |
| Fax | 2056057634 |
Authorized person
| Name | REES E OLIVER |
| Role | OWNER |
| Phone | 2058628879 |
Taxonomy
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| License Number | 114498 |
| State | AL |
| Is Primary | No |
| Taxonomy Code | 332BP3500X - Parenteral & Enteral Nutrition Supplies (DME) |
| License Number | 114498 |
| State | AL |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | 114498 |
| State | AL |
| Is Primary | No |
| Taxonomy Code | 3336H0001X - Home Infusion Therapy Pharmacy |
| License Number | 114498 |
| State | AL |
| Is Primary | Yes |
| Taxonomy Code | 3336S0011X - Specialty Pharmacy |
| License Number | 114498 |
| State | AL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 181123 |
| State | AL |
| Issuer | MEDICAID |
| Number | 177933 |
| State | AL |
| Issuer | BCBS AL |
| Number | 511-71266 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| OLIVER, REES | Agent | 625 FOUNDERS PARK DRIVE WESTHOOVER, AL 35226 |
Date of last update: 03 Aug 2024
Sources: Alabama Secretary of State
