Healthcare Provider Details
I. General information
NPI: 1013407675
Provider Name (Legal Business Name): ALABAMA RADIATION THERAPY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/18/2018
Last Update Date: 08/29/2022
Certification Date: 08/29/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3670 GRANDVIEW PKWY #100
BIRMINGHAM AL
35243
US
IV. Provider business mailing address
PO BOX 531006
ATLANTA GA
30353-1006
US
V. Phone/Fax
- Phone: 205-971-1800
- Fax:
- Phone: 800-329-1906
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0001X |
| Taxonomy | Radiation Oncology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ROBIN
MESSINA
Title or Position: CREDENTIALING
Credential:
Phone: 407-788-1906