Provider Demographics
NPI:1033125687
Name:MOBILE INFIRMARY ASSOCIATION
Entity Type:Organization
Organization Name:MOBILE INFIRMARY ASSOCIATION
Other - Org Name:J.L. BEDSOLE ROTARY REHAB HOSPITAL
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR, REIMBURSEMENT
Authorized Official - Prefix:
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:W
Authorized Official - Last Name:REDFOOT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-435-2290
Mailing Address - Street 1:5 MOBILE INFIRMARY CIR
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36607-3513
Mailing Address - Country:US
Mailing Address - Phone:251-435-5500
Mailing Address - Fax:
Practice Address - Street 1:5 MOBILE INFIRMARY CIR
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36607-3513
Practice Address - Country:US
Practice Address - Phone:251-435-5500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MOBILE INFIRMARY ASSOCIATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-01
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL11844273Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL=========OtherTAX ID
AL=========OtherTAX ID