Healthcare Provider Details

I. General information

NPI: 1720133184
Provider Name (Legal Business Name): INFIRMARY OCCUPATIONAL HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 11/15/2022
Certification Date: 11/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27961 US HIGHWAY 98 STE 25
DAPHNE AL
36526-4725
US

IV. Provider business mailing address

27961 US HIGHWAY 98 STE 25
DAPHNE AL
36526-4725
US

V. Phone/Fax

Practice location:
  • Phone: 251-625-8222
  • Fax: 251-625-8117
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ANTHONY PALAZZO
Title or Position: VP OF FINANCE
Credential:
Phone: 251-435-1361