Healthcare Provider Details

I. General information

NPI: 1417025917
Provider Name (Legal Business Name): ALABAMA REGIONAL MEDICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

712 25TH ST N
BIRMINGHAM AL
35203-2400
US

IV. Provider business mailing address

PO BOX 11523
BIRMINGHAM AL
35203
US

V. Phone/Fax

Practice location:
  • Phone: 205-323-5311
  • Fax: 205-439-7248
Mailing address:
  • Phone: 205-212-5600
  • Fax: 205-212-5660

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ANTHONY GARDNER
Title or Position: CEO
Credential:
Phone: 205-212-5654