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General NPI Number Information
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NPI Number | 1669753935
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Entity Type | Organization
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Legal Business Name | UNIVERSITY OF ALABAMA HEALTH SERVICES FOUNDATION, P.C.
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Dates
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Enumeration Date | 08/31/2011
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Last Update Date | 08/31/2011
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Provider Practice Location Address
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Address Line | 619 19TH ST S
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City | BIRMINGHAM
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State | AL
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Zip | 35249-1900
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Country | US
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Telephone | 870-352-1555
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Fax |
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Provider Business Mailing Address
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Address Line | 500 22ND ST S
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City | BIRMINGHAM
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State | AL
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Zip | 35233-3110
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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 | MEDICAL DIRECTOR OF MICU
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Name | DR. JAMES JOHNSON
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Credential | M.D.
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Telephone | 205-975-0787
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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License Number | 1-113826
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License Number State | AL
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