Provider Demographics
NPI:1346260874
Name:BIRMINGHAM SPEECH & HEARING ASSOC
Entity Type:Organization
Organization Name:BIRMINGHAM SPEECH & HEARING ASSOC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PAT
Authorized Official - Middle Name:
Authorized Official - Last Name:LACOSTE
Authorized Official - Suffix:
Authorized Official - Credentials:AUD FAA CCC A
Authorized Official - Phone:205-871-3878
Mailing Address - Street 1:4 OFFICE PARK CIRCLE
Mailing Address - Street 2:SUITE 301
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35223
Mailing Address - Country:US
Mailing Address - Phone:205-871-3878
Mailing Address - Fax:205-871-3902
Practice Address - Street 1:4 OFFICE PARK CIRCLE
Practice Address - Street 2:SUITE 301
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35223
Practice Address - Country:US
Practice Address - Phone:205-871-3878
Practice Address - Fax:205-871-3902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL721235Z00000X
AL281A237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Not Answered237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1263819OtherUMWA
AL51052072OtherBLUE CROSS BLUE SHIELD
AL1263819OtherUMWA