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General NPI Number Information
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NPI Number | 1528452562
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Entity Type | Organization
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Legal Business Name | OAKWOOD UNIVERSITY CHURCH HEALTH SERVICE
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Dates
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Enumeration Date | 03/27/2015
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Last Update Date | 03/27/2015
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Provider Practice Location Address
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Address Line | 5500 ADVENTIST BLVD NW SUITE 103
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City | HUNTSVILLE
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State | AL
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Zip | 35896-0002
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Country | US
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Telephone | 256-203-5185
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Fax |
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Provider Business Mailing Address
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Address Line | 5500 ADVENTIST BLVD NW SUITE 103
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City | HUNTSVILLE
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State | AL
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Zip | 35896-0002
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHAIR OF BOARD
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Name | CARLTON BYRD
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Credential |
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Telephone | 256-203-5185
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State | AL
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