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General NPI Number Information
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NPI Number | 1851690069
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Entity Type | Organization
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Legal Business Name | LIFELINE VASCULAR BIRMINGHAM, INC
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Dates
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Enumeration Date | 03/28/2011
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Last Update Date | 03/28/2011
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Provider Practice Location Address
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Address Line | 201 LONDON PKWY SUITE 500
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City | BIRMINGHAM
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State | AL
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Zip | 35211-6304
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Country | US
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Telephone | 205-942-9896
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Fax | 205-942-9948
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Provider Business Mailing Address
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Address Line | 3 HAWTHORN PKWY SUITE 410
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City | VERNON HILLS
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State | IL
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Zip | 60061-1446
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Country | US
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Telephone | 847-388-2001
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Fax | 847-388-2020
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Authorized Official
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Title or Position | VP CONTROLLER
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Name | JAMES HILGER
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Credential |
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Telephone | 253-280-9501
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number |
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License Number State |
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