Healthcare Provider Details

I. General information

NPI: 1154571354
Provider Name (Legal Business Name): PRINCETON BAPTIST MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2008
Last Update Date: 09/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 PRINCETON AVE SW DEPT. OF WOMEN AND INFANTS
BIRMINGHAM AL
35211-1303
US

IV. Provider business mailing address

701 PRINCETON AVE SW DEPT. OF WOMEN AND INFANTS
BIRMINGHAM AL
35211-1303
US

V. Phone/Fax

Practice location:
  • Phone: 205-783-7174
  • Fax: 205-783-3030
Mailing address:
  • Phone: 205-783-7174
  • Fax: 205-783-3030

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number2083P0901X
License Number StateAL

VIII. Authorized Official

Name: MS. MARCIA MITCHELL DAVIS
Title or Position: CERTIFIED CHILDBIRTH EDUCATOR
Credential: R.N.
Phone: 205-783-7174