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General NPI Number Information
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NPI Number | 1043892672
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Entity Type | Organization
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Legal Business Name | CORELIFE ALABAMA LLC
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Dates
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Enumeration Date | 04/23/2021
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Last Update Date | 10/14/2021
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Provider Practice Location Address
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Address Line | 3829 LORNA RD
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City | HOOVER
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State | AL
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Zip | 35244-7034
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Country | US
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Telephone | 205-710-2368
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Fax |
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Provider Business Mailing Address
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Address Line | 1111 BENFIELD BLVD STE 250
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City | MILLERSVILLE
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State | MD
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Zip | 21108
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Country | US
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Telephone | 443-688-6909
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Fax |
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Authorized Official
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Title or Position | DIRECTOR, RCM
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Name | KELLY SHEEHAN
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Credential |
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Telephone | 443-439-6309
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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