Healthcare Provider Details

I. General information

NPI: 1700751427
Provider Name (Legal Business Name): AOA OBSS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2025
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 19TH ST S
BIRMINGHAM AL
35205-4804
US

IV. Provider business mailing address

1000 19TH ST S
BIRMINGHAM AL
35205-4804
US

V. Phone/Fax

Practice location:
  • Phone: 205-930-0700
  • Fax:
Mailing address:
  • Phone: 205-930-0700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QS0132X
TaxonomyOphthalmologic Surgery Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JESSICA SHOREY
Title or Position: BILLING MANAGER
Credential:
Phone: 336-404-5722