Healthcare Provider Details

I. General information

NPI: 1033125687
Provider Name (Legal Business Name): MOBILE INFIRMARY ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 MOBILE INFIRMARY CIR
MOBILE AL
36607-3513
US

IV. Provider business mailing address

5 MOBILE INFIRMARY CIR
MOBILE AL
36607-3513
US

V. Phone/Fax

Practice location:
  • Phone: 251-435-5500
  • Fax:
Mailing address:
  • Phone: 251-435-5500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273Y00000X
TaxonomyRehabilitation Hospital Unit
License Number11844
License Number StateAL

VIII. Authorized Official

Name: RANDY W REDFOOT
Title or Position: DIRECTOR, REIMBURSEMENT
Credential:
Phone: 251-435-2290