Healthcare Provider Details

I. General information

NPI: 1548863210
Provider Name (Legal Business Name): USA HEALTH HCA INDUSTRIAL MEDICINE CLINIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2020
Last Update Date: 10/28/2021
Certification Date: 10/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1976 MICHIGAN AVE
MOBILE AL
36615-1114
US

IV. Provider business mailing address

3929-1 AIRPORT BLVD 5TH FLOOR, ROOM 513
MOBILE AL
36609
US

V. Phone/Fax

Practice location:
  • Phone: 251-660-5910
  • Fax: 251-660-5911
Mailing address:
  • Phone: 251-318-2681
  • Fax: 251-378-6222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ERICA MADISON
Title or Position: CREDENTIALING
Credential:
Phone: 251-318-2681