Healthcare Provider Details

I. General information

NPI: 1073827283
Provider Name (Legal Business Name): UAB UNIVERSITY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2010
Last Update Date: 07/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

SW W513 619 19TH STREET SOUTH
BIRMINGHAM AL
35249-0001
US

IV. Provider business mailing address

SW W513 619 19TH STREET SOUTH
BIRMINGHAM AL
35249-0001
US

V. Phone/Fax

Practice location:
  • Phone: 205-975-6167
  • Fax:
Mailing address:
  • Phone: 205-975-6167
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number StateAL

VIII. Authorized Official

Name: MS. SUSAN CONRAD
Title or Position: ADMINISTRATIVE DIRECTOR
Credential: MSN, RN
Phone: 205-934-2351