Healthcare Provider Details

I. General information

NPI: 1255598934
Provider Name (Legal Business Name): UAHSF PC DEPARTMENT OF PEDS HEMOC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2008
Last Update Date: 05/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 7TH AVE S
BIRMINGHAM AL
35233-1711
US

IV. Provider business mailing address

703 VOLKER HL
BIRMINGHAM AL
35294-0001
US

V. Phone/Fax

Practice location:
  • Phone: 205-939-9100
  • Fax:
Mailing address:
  • Phone: 205-934-3795
  • Fax: 205-975-2499

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: REID JONES
Title or Position: EXECUTIVE VICE PRESIDENT UAHSF
Credential:
Phone: 205-934-3795