Healthcare Provider Details

I. General information

NPI: 1114342607
Provider Name (Legal Business Name): THE HEALTH CARE AUTHORITY FOR BAPTIST HEALTH, AN AFFILIATE OF UABHS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2014
Last Update Date: 02/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1637 PERRY HILL RD
MONTGOMERY AL
36106-2729
US

IV. Provider business mailing address

301 BROWN SPRINGS RD
MONTGOMERY AL
36117-7005
US

V. Phone/Fax

Practice location:
  • Phone: 334-245-2800
  • Fax:
Mailing address:
  • Phone: 334-273-4508
  • Fax: 334-273-4290

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2083P0500X
TaxonomyPreventive Medicine/Occupational Environmental Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. KATRINA KEEFER BELT
Title or Position: SENIOR VP, CHIEF FINANCIAL OFFICER
Credential:
Phone: 334-273-4406