Healthcare Provider Details

I. General information

NPI: 1508437112
Provider Name (Legal Business Name): ALEGIS CARE - ALABAMA PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2021
Last Update Date: 07/16/2024
Certification Date: 07/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 CORPORATE DR STE 200
BIRMINGHAM AL
35242-2733
US

IV. Provider business mailing address

730 COOL SPRINGS BLVD STE 500
FRANKLIN TN
37067-7331
US

V. Phone/Fax

Practice location:
  • Phone: 773-292-4800
  • Fax: 312-564-4059
Mailing address:
  • Phone: 773-292-4800
  • Fax: 312-564-4059

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207PH0002X
TaxonomyHospice and Palliative Medicine (Emergency Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: GRACE BLUE
Title or Position: CREDENTIALING SR. MANAGER
Credential:
Phone: 773-292-4800