Provider Demographics
NPI:1376836163
Name:AUBURN UNIVERSITY
Entity Type:Organization
Organization Name:AUBURN UNIVERSITY
Other - Org Name:STATE EMPLOYEE'S INSURANCE BOARD HEALTHCARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:PEDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-844-4099
Mailing Address - Street 1:101 SOUTH UNION STREET
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36104
Mailing Address - Country:US
Mailing Address - Phone:334-844-8670
Mailing Address - Fax:334-844-8256
Practice Address - Street 1:101 S UNION ST
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36130-3022
Practice Address - Country:US
Practice Address - Phone:334-263-8470
Practice Address - Fax:334-263-8670
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-26
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service