Healthcare Provider Details

I. General information

NPI: 1376136929
Provider Name (Legal Business Name): ST. VINCENT'S ST. CLAIR, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2021
Last Update Date: 02/15/2021
Certification Date: 02/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7063 VETERANS PKWY
PELL CITY AL
35125-5114
US

IV. Provider business mailing address

7063 VETERANS PKWY
PELL CITY AL
35125-5114
US

V. Phone/Fax

Practice location:
  • Phone: 205-814-2126
  • Fax:
Mailing address:
  • Phone: 205-814-2126
  • Fax:

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: KATHLEEN HEDRICK
Title or Position: DIRECTOR NET REV MANAGMENT
Credential:
Phone: 205-212-6652