Healthcare Provider Details

I. General information

NPI: 1346307733
Provider Name (Legal Business Name): UNIVERSITY OF ALABAMA AT BIRMINGHAM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2007
Last Update Date: 01/15/2026
Certification Date: 01/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 11TH AVE S
BIRMINGHAM AL
35205-3423
US

IV. Provider business mailing address

1201 11TH AVE S
BIRMINGHAM AL
35205-3423
US

V. Phone/Fax

Practice location:
  • Phone: 205-930-7585
  • Fax: 205-930-7587
Mailing address:
  • Phone: 205-930-7585
  • Fax: 205-930-7587

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number112793
License Number StateAL
# 3
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER PETERSON
Title or Position: DIR AMBULATORY PHCY SERV.
Credential:
Phone: 205-934-7862