MEDICARE: ST. VINCENT'S HOSPITAL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	335V00000X	Portable X-ray and/or Other Portable Diagnostic Imaging Supplier

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	K591	OTHER	AL	MEDICARE PART B BILLING

General Provider Information

NPI Number	:	1134255409
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ST. VINCENT'S HOSPITAL

Provider Business Mailing Address
First Line	:	810 SAINT VINCENTS DR
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35205-1601
Country	:	US
Telephone Number	:	205-314-8834
Fax Number	:

Provider Business Practice Location Address
First Line	:	105 CHURCH ST
Second Line	:
City	:	RAINBOW CITY
State	:	AL
Zip	:	35906-6242
Country	:	US
Telephone Number	:	205-314-8834
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	BRANDON WILLIAMS
Credential	:
Telephone Number	:	205-838-3718

Provider Enumeration Date	:	02/23/2007
Last Update Date	:	09/06/2017

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Directions to “ST. VINCENT'S HOSPITAL ” Practice Location

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