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General NPI Number Information
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NPI Number | 1033213624
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Entity Type | Organization
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Legal Business Name | STATE OF ALABAMA DEPT OF FINANCE
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Dates
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Enumeration Date | 09/12/2006
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Last Update Date | 05/09/2024
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Provider Practice Location Address
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Address Line | 115 HARPER COURT
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City | TUSCALOOSA
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State | AL
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Zip | 35401
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Country | US
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Telephone | 205-366-3010
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Fax | 205-366-3012
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Provider Business Mailing Address
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Address Line | PO BOX 21231
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City | TUSCALOOSA
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State | AL
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Zip | 35402
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Country | US
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Telephone | 205-366-3010
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Fax | 205-366-3012
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Authorized Official
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Title or Position | ACCOUNTING ASSISTANT II
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Name | MELISSA D SHAW
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Credential |
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Telephone | 205-366-3038
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number |
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License Number State | AL
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