Provider Demographics
NPI:1497097208
Name:INFIRMARY HEALTH SYSTEM
Entity Type:Organization
Organization Name:INFIRMARY HEALTH SYSTEM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF CLINIC OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-435-1360
Mailing Address - Street 1:8609 PINE RUN
Mailing Address - Street 2:
Mailing Address - City:SPANISH FORT
Mailing Address - State:AL
Mailing Address - Zip Code:36527-8637
Mailing Address - Country:US
Mailing Address - Phone:251-610-5212
Mailing Address - Fax:
Practice Address - Street 1:1720 SPRING HILL AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36604-1410
Practice Address - Country:US
Practice Address - Phone:251-435-1770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-19
Last Update Date:2013-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-119026261QM0855X, 273Y00000X, 282N00000X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute CareGroup - Single Specialty
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No273Y00000XHospital UnitsRehabilitation Unit
No282N00000XHospitalsGeneral Acute Care Hospital