Healthcare Provider Details

I. General information

NPI: 1225151087
Provider Name (Legal Business Name): THE CHILDREN'S HOSPITAL OF ALABAMA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2007
Last Update Date: 09/18/2020
Certification Date: 09/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 7TH AVE S GROUND FLOOR PHARMACY
BIRMINGHAM AL
35233-1711
US

IV. Provider business mailing address

1600 7TH AVE S GROUND FLOOR PHARMACY
BIRMINGHAM AL
35233-1711
US

V. Phone/Fax

Practice location:
  • Phone: 205-939-9714
  • Fax: 205-939-9794
Mailing address:
  • Phone: 205-939-9714
  • Fax: 205-939-9794

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License Number120060
License Number StateAL

VIII. Authorized Official

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