Provider Demographics
NPI:1407283625
Name:ALABAMA HEART AND LUNG SURGERY CENTER, LLC
Entity Type:Organization
Organization Name:ALABAMA HEART AND LUNG SURGERY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:GLEN
Authorized Official - Last Name:CROWE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:334-528-5900
Mailing Address - Street 1:2000 PEPPERELL PKWY
Mailing Address - Street 2:BUILDING 190
Mailing Address - City:OPELIKA
Mailing Address - State:AL
Mailing Address - Zip Code:36801-5452
Mailing Address - Country:US
Mailing Address - Phone:334-528-5900
Mailing Address - Fax:334-528-5899
Practice Address - Street 1:2000 PEPPERELL PKWY
Practice Address - Street 2:BUILDING 190
Practice Address - City:OPELIKA
Practice Address - State:AL
Practice Address - Zip Code:36801-5452
Practice Address - Country:US
Practice Address - Phone:334-528-5900
Practice Address - Fax:334-528-5899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-02
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL22312208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty