Provider Demographics
NPI:1215187497
Name:ALABAMA HEART CARE LLC
Entity Type:Organization
Organization Name:ALABAMA HEART CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ANAND
Authorized Official - Middle Name:
Authorized Official - Last Name:PANDEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-242-3013
Mailing Address - Street 1:3909 GAINESWOOD LN
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35406-3568
Mailing Address - Country:US
Mailing Address - Phone:205-242-3013
Mailing Address - Fax:
Practice Address - Street 1:4810 HARKEY LANE
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35406
Practice Address - Country:US
Practice Address - Phone:205-344-6344
Practice Address - Fax:205-344-6464
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-24
Last Update Date:2010-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL20271207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL510-47575OtherBLUE CROSS BLUE SHIELD
AL1215187497Medicaid
ALG43809Medicare UPIN
AL510-47575OtherBLUE CROSS BLUE SHIELD