Provider Demographics
NPI:1174186225
Name:MOTHERS' MILK BANK OF ALABAMA
Entity Type:Organization
Organization Name:MOTHERS' MILK BANK OF ALABAMA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:HABCHI
Authorized Official - Suffix:
Authorized Official - Credentials:CLC
Authorized Official - Phone:205-942-8911
Mailing Address - Street 1:107 WALTER DAVIS DR
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-2803
Mailing Address - Country:US
Mailing Address - Phone:205-942-8911
Mailing Address - Fax:205-942-8838
Practice Address - Street 1:107 WALTER DAVIS DR
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-2803
Practice Address - Country:US
Practice Address - Phone:205-942-8911
Practice Address - Fax:205-942-8838
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-15
Last Update Date:2019-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition