Healthcare Provider Details

I. General information

NPI: 1518975887
Provider Name (Legal Business Name): AMSOL ANESTHETISTS OF ALABAMA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2006
Last Update Date: 06/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 S 3RD ST
GADSDEN AL
35901-5304
US

IV. Provider business mailing address

PO BOX 10824
BIRMINGHAM AL
35202-0824
US

V. Phone/Fax

Practice location:
  • Phone: 888-245-5525
  • Fax: 717-653-8197
Mailing address:
  • Phone: 888-245-5525
  • Fax: 717-653-8197

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: ALAN DALE HILLIARD
Title or Position: CFO
Credential: CPA
Phone: 336-899-1410