Healthcare Provider Details

I. General information

NPI: 1902346372
Provider Name (Legal Business Name): HEMATOLOGY & ONCOLOGY ASSOCIATES OF ALABAMA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2017
Last Update Date: 07/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

513 BROOKWOOD BLVD STE 65
BIRMINGHAM AL
35209-6862
US

IV. Provider business mailing address

PO BOX 131329
BIRMINGHAM AL
35213-6329
US

V. Phone/Fax

Practice location:
  • Phone: 205-209-3514
  • Fax: 205-847-5172
Mailing address:
  • Phone: 205-209-3514
  • Fax: 205-847-5172

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 Number114728
License Number StateAL

VIII. Authorized Official

Name: ALLEN YEILDING
Title or Position: VICE PRESIDENT
Credential:
Phone: 205-271-8541