Healthcare Provider Details

I. General information

NPI: 1578064614
Provider Name (Legal Business Name): ALABAMA REGIONAL MEDICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2018
Last Update Date: 04/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 6TH AVE S FL 7
BIRMINGHAM AL
35233-1601
US

IV. Provider business mailing address

PO BOX 11526
BIRMINGHAM AL
35202-1526
US

V. Phone/Fax

Practice location:
  • Phone: 205-212-5600
  • Fax:
Mailing address:
  • Phone: 205-407-5600
  • Fax: 205-407-5611

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: 205-407-5654