Healthcare Provider Details

I. General information

NPI: 1992489223
Provider Name (Legal Business Name): USA HEALTH HCA PROVIDENCE HOSPITAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2023
Last Update Date: 02/12/2025
Certification Date: 02/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6801 AIRPORT BLVD
MOBILE AL
36608-3709
US

IV. Provider business mailing address

PO BOX 931131
ATLANTA GA
31193-1131
US

V. Phone/Fax

Practice location:
  • Phone: 251-633-1000
  • Fax:
Mailing address:
  • Phone: 251-460-6101
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: BENNY J STOVER
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 251-445-9164