Healthcare Provider Details

I. General information

NPI: 1184213126
Provider Name (Legal Business Name): BHIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/14/2021
Last Update Date: 01/14/2021
Certification Date: 01/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 INDEPENDENCE PLZ STE 600
HOMEWOOD AL
35209-2659
US

IV. Provider business mailing address

PO BOX 14022
HUNTSVILLE AL
35815-0022
US

V. Phone/Fax

Practice location:
  • Phone: 833-637-7924
  • Fax: 334-625-7602
Mailing address:
  • Phone: 256-384-8264
  • Fax: 256-427-4150

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: SHANKAR B YALAMANCHILI
Title or Position: PSYCHIATRIST/OWNER
Credential: M.D.
Phone: 334-239-2622