Provider Demographics
NPI:1063477644
Name:MOBILE HEART SPECIALISTS PC
Entity Type:Organization
Organization Name:MOBILE HEART SPECIALISTS PC
Other - Org Name:THE HEART GROUP, P.C.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:BELINDA
Authorized Official - Middle Name:L
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-435-8572
Mailing Address - Street 1:6701 AIRPORT BLVD
Mailing Address - Street 2:SUITE A-107
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36608-6705
Mailing Address - Country:US
Mailing Address - Phone:251-433-4700
Mailing Address - Fax:251-435-8615
Practice Address - Street 1:6701 AIRPORT BLVD
Practice Address - Street 2:SUITE A-107
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-6705
Practice Address - Country:US
Practice Address - Phone:251-433-4700
Practice Address - Fax:251-435-8615
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-18
Last Update Date:2013-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL00119745Medicaid
AL000029329Medicaid
MS09014562Medicaid
AL1558349860OtherNPI
ALC2022OtherRAILROAD MEDICARE
AL000008468Medicaid
AL009902515Medicaid
AL000033302Medicaid
AL1114905429OtherNPI
AL1467433524OtherNPI
ALG363OtherMEDICARE GRP MOBILE INF
ALG364OtherMEDICARE GRP PROV
MS00115660Medicaid
MS00126607Medicaid
AL1982685640OtherNPI
AL529601560Medicaid
MS00121124Medicaid
AL1467433524OtherNPI
ALG364OtherMEDICARE GRP PROV
ALC2022OtherRAILROAD MEDICARE
AL000033302Medicaid
AL08468Medicare PIN