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General NPI Number Information
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NPI Number | 1497097208
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Entity Type | Organization
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Legal Business Name | INFIRMARY HEALTH SYSTEM
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Dates
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Enumeration Date | 03/19/2013
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Last Update Date | 03/19/2013
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Provider Practice Location Address
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Address Line | 1720 SPRING HILL AVE SUITE 300
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City | MOBILE
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State | AL
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Zip | 36604-1410
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Country | US
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Telephone | 251-435-1770
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Fax |
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Provider Business Mailing Address
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Address Line | 8609 PINE RUN
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City | SPANISH FORT
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State | AL
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Zip | 36527-8637
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Country | US
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Telephone | 251-610-5212
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF CLINIC OPERATIONS
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Name | KIM MARTIN
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Credential |
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Telephone | 251-435-1360
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number | 1-119026
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 273Y00000X
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Taxonomy Name | Rehabilitation Hospital Unit
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License Number | 1-119026
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License Number State | AL
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Taxonomy #3
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 1-119026
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License Number State | AL
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Taxonomy #4
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 1-119026
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License Number State | AL
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