Healthcare Provider Details

I. General information

NPI: 1184700288
Provider Name (Legal Business Name): THE CHILDREN'S HOSPITAL OF ALABAMA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 7TH AVE S DEPT. OF HEARING & SPEECH
BIRMINGHAM AL
35233-1711
US

IV. Provider business mailing address

1600 7TH AVE S DEPT. OF HEARING & SPEECH
BIRMINGHAM AL
35233-1711
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number11819
License Number StateAL

VIII. Authorized Official

Name: MRS. DAWN H WALTON
Title or Position: CONTROLLER
Credential: CPA
Phone: 205-939-9073