Healthcare Provider Details
I. General information
NPI: 1447369525
Provider Name (Legal Business Name): THE CHILDREN'S HOSPITAL OF ALABAMA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/30/2006
Last Update Date: 09/18/2020
Certification Date: 09/18/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1512 5TH AVE S
BIRMINGHAM AL
35233-1615
US
IV. Provider business mailing address
1600 7TH AVE S
BIRMINGHAM AL
35233-1711
US
V. Phone/Fax
- Phone: 205-975-2645
- Fax: 205-252-4471
- Phone: 205-975-2645
- Fax: 205-252-4471
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3416L0300X |
| Taxonomy | Land Ambulance |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3416A0800X |
| Taxonomy | Air Ambulance |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DAWN
WALTON
Title or Position: CFO
Credential:
Phone: 205-638-9901