Organization Name: | BRENDA L CASSELBERRY |
NPI Number: | 1568649754 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BRENDA L CASSELBERRY (PHYSICIAN / PRESIDENT) |
Mailing Address: | 2121 Executive Park Dr Opelika |
State: | AL US |
Postal Code: | 368016041 |
Phone Number: | 3347050544 |
Fax Number: | 3347050531 |
NPI Enumeration Date: | 01/30/2008 |
NPI Last Update Date: | 01/07/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | 132 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | AL |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |