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General NPI Number Information
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NPI Number | 1952188013
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Entity Type | Organization
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Legal Business Name | KIDS HEALTH INC.
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Dates
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Enumeration Date | 09/12/2023
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Last Update Date | 09/12/2023
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Provider Practice Location Address
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Address Line | 119 STEPHEN J WHITE MEMORIAL BLVD
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City | TALLADEGA
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State | AL
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Zip | 35160-2106
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Country | US
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Telephone | 256-268-7775
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Fax |
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Provider Business Mailing Address
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Address Line | 119 STEPHEN J WHITE MEMORIAL BLVD
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City | TALLADEGA
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State | AL
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Zip | 35160-2106
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Country | US
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Telephone | 256-268-7775
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Fax |
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Authorized Official
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Title or Position | MANAGING DIRECTOR
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Name | NICOLE GURLEY
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Credential |
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Telephone | 256-268-7775
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number |
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License Number State |
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