Provider Demographics
NPI:1013282359
Name:NET AL
Entity type:Organization
Organization Name:NET AL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DEBORA
Authorized Official - Middle Name:
Authorized Official - Last Name:COLEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-316-5899
Mailing Address - Street 1:PO BOX 295
Mailing Address - Street 2:
Mailing Address - City:RIDGELAND
Mailing Address - State:MS
Mailing Address - Zip Code:39158-0295
Mailing Address - Country:US
Mailing Address - Phone:334-649-1103
Mailing Address - Fax:334-264-8825
Practice Address - Street 1:8448 CROSSLAND LOOP
Practice Address - Street 2:SUITE 142
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-0950
Practice Address - Country:US
Practice Address - Phone:334-649-1103
Practice Address - Fax:334-264-8825
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-20
Last Update Date:2012-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies