Healthcare Provider Details

I. General information

NPI: 1255395471
Provider Name (Legal Business Name): BHC - BESSEMER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2006
Last Update Date: 03/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 LAKE DR SE SUITE 101
BESSEMER AL
35022-6490
US

IV. Provider business mailing address

PO BOX 830605
BIRMINGHAM AL
35283-0605
US

V. Phone/Fax

Practice location:
  • Phone: 205-426-8708
  • Fax: 205-426-2689
Mailing address:
  • Phone: 205-715-5943
  • Fax: 205-715-5932

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: G. SCOTT FENN
Title or Position: PRESIDENT & CEO
Credential:
Phone: 205-715-5415