Healthcare Provider Details

I. General information

NPI: 1669436705
Provider Name (Legal Business Name): BHC - OCCUPATIONAL MEDICINE REHAB
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2006
Last Update Date: 03/05/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

833 PRINCETON AVE SW POB III; SUITE 150
BIRMINGHAM AL
35211-1323
US

IV. Provider business mailing address

PO BOX 830605
BIRMINGHAM AL
35283-0605
US

V. Phone/Fax

Practice location:
  • Phone: 205-781-2699
  • Fax: 205-781-2690
Mailing address:
  • Phone: 205-715-5904
  • Fax: 205-715-5928

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: G. SCOTT FENN
Title or Position: CHIEF INTEGRATION OFFICIER
Credential:
Phone: 205-715-5415