Provider Demographics
NPI:1518010719
Name:VETERANS HOSPITAL
Entity Type:Organization
Organization Name:VETERANS HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CRNP
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:205-933-8101
Mailing Address - Street 1:4405 SO. SHADES CREST RD
Mailing Address - Street 2:
Mailing Address - City:BESSEMER
Mailing Address - State:AL
Mailing Address - Zip Code:35022
Mailing Address - Country:US
Mailing Address - Phone:205-481-3566
Mailing Address - Fax:
Practice Address - Street 1:700 SOUTH 19TH STREET
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233
Practice Address - Country:US
Practice Address - Phone:205-933-8101
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-026106275N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit