Provider Demographics
NPI:1477610806
Name:DELTAMED, INC.
Entity Type:Organization
Organization Name:DELTAMED, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GREG
Authorized Official - Middle Name:
Authorized Official - Last Name:BAIRD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-879-5155
Mailing Address - Street 1:2767 BM MONTGOMERY ST
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-1841
Mailing Address - Country:US
Mailing Address - Phone:205-879-5155
Mailing Address - Fax:205-879-1007
Practice Address - Street 1:2767 BM MONTGOMERY ST
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-1841
Practice Address - Country:US
Practice Address - Phone:205-879-5155
Practice Address - Fax:205-879-1007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL493332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51031674OtherBCBS PROVIDER NUMBER
AL51031674OtherBCBS PROVIDER NUMBER