Healthcare Provider Details

I. General information

NPI: 1487609962
Provider Name (Legal Business Name): AHC FOX-REDSTONE ARSENAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 05/21/2025
Certification Date: 05/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4100 GOSS RD SW
HUNTSVILLE AL
35809-0001
US

IV. Provider business mailing address

4100 GOSS RD ATTN MCXW PAD INS OFFICE
REDSTONE ARSENAL AL
35809-0000
US

V. Phone/Fax

Practice location:
  • Phone: 256-955-8888
  • Fax:
Mailing address:
  • Phone: 256-876-4464
  • Fax: 256-955-6337

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM1101X
TaxonomyMilitary and U.S. Coast Guard Ambulatory Procedure Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM1100X
TaxonomyMilitary/U.S. Coast Guard Outpatient Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: WADE HAMLETT
Title or Position: UBO MANAGER
Credential:
Phone: 256-876-4464