Healthcare Provider Details
I. General information
NPI: 1215559968
Provider Name (Legal Business Name): MOBILE INFIRMARY ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/15/2020
Last Update Date: 03/27/2026
Certification Date: 03/27/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5 MOBILE INFIRMARY CIR
MOBILE AL
36607-3513
US
IV. Provider business mailing address
PO BOX 2144
MOBILE AL
36652-2144
US
V. Phone/Fax
- Phone: 251-435-5037
- Fax:
- Phone: 251-435-5037
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 291U00000X |
| Taxonomy | Clinical Medical Laboratory |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
RANDY
REDFOOT
Title or Position: DIRECTOR OF REIMBURSEMENT
Credential:
Phone: 251-435-2290