Provider Demographics
NPI:1346684008
Name:UNIVERSITY OF ALABAMA AT BIRMINGHAM HOSPITAL
Entity Type:Organization
Organization Name:UNIVERSITY OF ALABAMA AT BIRMINGHAM HOSPITAL
Other - Org Name:UAB HOSPITAL
Other - Org Type:Other Name
Authorized Official - Title/Position:ASSOCIATE PROFESSOR
Authorized Official - Prefix:
Authorized Official - First Name:MAMERHI
Authorized Official - Middle Name:
Authorized Official - Last Name:OKOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-996-7356
Mailing Address - Street 1:FOT 1034 1530 3RD AVE S
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35294-3410
Mailing Address - Country:US
Mailing Address - Phone:205-996-7356
Mailing Address - Fax:
Practice Address - Street 1:FOT 1034 1530 3RD AVE S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35294-3410
Practice Address - Country:US
Practice Address - Phone:205-996-7356
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-24
Last Update Date:2013-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-073990282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital