Healthcare Provider Details

I. General information

NPI: 1982418141
Provider Name (Legal Business Name): EASTERN HOSPITAL MEDICINE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2025
Last Update Date: 02/06/2025
Certification Date: 02/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 MEDICAL PARK DR E
BIRMINGHAM AL
35235-3401
US

IV. Provider business mailing address

PO BOX 830674
BIRMINGHAM AL
35283-0674
US

V. Phone/Fax

Practice location:
  • Phone: 205-838-3000
  • Fax:
Mailing address:
  • Phone: 205-874-8300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2278G0305X
TaxonomyGeriatric Care Certified Respiratory Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2279S1500X
TaxonomySNF/Subacute Care Registered Respiratory Therapist
License Number
License Number State

VIII. Authorized Official

Name: LEE T WIMBERLY
Title or Position: CEO
Credential: MD
Phone: 205-874-8306