Healthcare Provider Details

I. General information

NPI: 1699035675
Provider Name (Legal Business Name): UAB HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2012
Last Update Date: 05/23/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

SW S517 619 19TH ST S
BIRMINGHAM AL
35249-0001
US

IV. Provider business mailing address

SW S517 619 19TH ST S
BIRMINGHAM AL
35249-0001
US

V. Phone/Fax

Practice location:
  • Phone: 205-934-8346
  • Fax:
Mailing address:
  • Phone: 205-934-8346
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number1-102647
License Number StateAL

VIII. Authorized Official

Name: MRS. EMILY BALLARD MCNEARNEY
Title or Position: NURSE PRACTITIONER
Credential: CRNP
Phone: 205-566-6919