Provider Demographics
NPI:1548939937
Name:SUNBRIDGE HOME HEALTH CARE, INC.
Entity type:Organization
Organization Name:SUNBRIDGE HOME HEALTH CARE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF ADMINISTRATIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:RANDALL
Authorized Official - Middle Name:D'WAYNE
Authorized Official - Last Name:POE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:256-238-3800
Mailing Address - Street 1:PO BOX 2615
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35602-2615
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:651 BEACON PKWY W STE 201
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-3128
Practice Address - Country:US
Practice Address - Phone:256-238-3800
Practice Address - Fax:205-202-2580
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-08
Last Update Date:2021-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care