Provider Demographics
NPI:1477003226
Name:VITURO HEALTH OF ALABAMA, LLC
Entity Type:Organization
Organization Name:VITURO HEALTH OF ALABAMA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CLEVELAND
Authorized Official - Middle Name:
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-515-5401
Mailing Address - Street 1:2901 2ND AVE S STE 130
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35233-2928
Mailing Address - Country:US
Mailing Address - Phone:941-371-3900
Mailing Address - Fax:
Practice Address - Street 1:2901 2ND AVE S
Practice Address - Street 2:SUITE 130
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-2900
Practice Address - Country:US
Practice Address - Phone:941-371-3900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-05
Last Update Date:2016-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty