Provider Demographics
NPI:1609919265
Name:DP HOME HEALTH CARE ASSOCIATES INC
Entity type:Organization
Organization Name:DP HOME HEALTH CARE ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:L
Authorized Official - Last Name:PONQUINETTE
Authorized Official - Suffix:
Authorized Official - Credentials:PD, CDM
Authorized Official - Phone:251-471-2113
Mailing Address - Street 1:PO BOX 1342
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36633-1342
Mailing Address - Country:US
Mailing Address - Phone:251-471-2113
Mailing Address - Fax:251-476-1672
Practice Address - Street 1:2168 A ST. STEPHENS ROAD
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36617-3732
Practice Address - Country:US
Practice Address - Phone:251-471-2113
Practice Address - Fax:251-476-1672
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2013-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL118332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000054625Medicaid
AL51054625OtherBLUE CROSS BLUE SHIELD
AL000054625Medicaid