Healthcare Provider Details

I. General information

NPI: 1295850287
Provider Name (Legal Business Name): ALABAMA HEALTH SERVICES ST CLAIR LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 09/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2805 DR JOHN HAYNES DR
PELL CITY AL
35125-1448
US

IV. Provider business mailing address

PO BOX 2726
BIRMINGHAM AL
35202-2726
US

V. Phone/Fax

Practice location:
  • Phone: 205-338-3301
  • Fax:
Mailing address:
  • Phone: 205-322-1808
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: BRANDON WILLIAMS
Title or Position: CFO
Credential:
Phone: 205-838-3426