Healthcare Provider Details

I. General information

NPI: 1366526865
Provider Name (Legal Business Name): USA HEALTH SERVICES FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 11/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2451 FILLINGIM ST MOORER BLDG #1119
MOBILE AL
36617-2238
US

IV. Provider business mailing address

PO BOX 40480
MOBILE AL
36640-0480
US

V. Phone/Fax

Practice location:
  • Phone: 251-471-7790
  • Fax: 251-471-7715
Mailing address:
  • Phone: 251-470-5842
  • Fax: 251-470-5809

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: BECKY S. TATE
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 251-470-5842