Healthcare Provider Details

I. General information

NPI: 1205935012
Provider Name (Legal Business Name): THE CHILDREN'S HOSPITAL OF ALABAMA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 03/29/2021
Certification Date: 03/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 7TH AVE S
BIRMINGHAM AL
35233-1711
US

IV. Provider business mailing address

PO BOX 114070536
BIRMINGHAM AL
35246-0536
US

V. Phone/Fax

Practice location:
  • Phone: 205-638-9100
  • Fax: 205-939-9189
Mailing address:
  • Phone: 205-638-5600
  • Fax: 205-638-5623

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC2000X
TaxonomyChildren's Hospital
License Number11819
License Number StateAL

VIII. Authorized Official

Name: DAWN WALTON
Title or Position: CFO
Credential:
Phone: 205-638-9901