Provider Demographics
NPI:1083267900
Name:HCA FOR BAPTIST HEALTH, AN AFFILIATE OF UAB HEALTH SYSTEM
Entity Type:Organization
Organization Name:HCA FOR BAPTIST HEALTH, AN AFFILIATE OF UAB HEALTH SYSTEM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF FINANCIAL MANAGEMENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:BRUTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-273-4258
Mailing Address - Street 1:301 BROWN SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-7005
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4371 NARROW LANE RD STE 100
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36116-2975
Practice Address - Country:US
Practice Address - Phone:334-613-3680
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HCA FOR BAPTIST HEALTH, AN AFFILIATE OF UAB HEALTH SYSTEM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-07-19
Last Update Date:2019-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL158376Medicaid