Provider Demographics
NPI:1033579024
Name:ST. VINCENT'S EAST FAMILY PRACTICE
Entity Type:Organization
Organization Name:ST. VINCENT'S EAST FAMILY PRACTICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-838-6000
Mailing Address - Street 1:2152 OLD SPRINGVILLE RD
Mailing Address - Street 2:
Mailing Address - City:CENTER POINT
Mailing Address - State:AL
Mailing Address - Zip Code:35215-4005
Mailing Address - Country:US
Mailing Address - Phone:205-838-6000
Mailing Address - Fax:
Practice Address - Street 1:2152 OLD SPRINGVILLE RD
Practice Address - Street 2:
Practice Address - City:CENTER POINT
Practice Address - State:AL
Practice Address - Zip Code:35215-4005
Practice Address - Country:US
Practice Address - Phone:205-838-6000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ASCENSION HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-03-03
Last Update Date:2017-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALL.4157R282NR1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NR1301XHospitalsGeneral Acute Care HospitalRural