Provider Demographics
NPI:1558364802
Name:MOBILE INFIRMARY ASSOCIATION
Entity Type:Organization
Organization Name:MOBILE INFIRMARY ASSOCIATION
Other - Org Name:MOBILE INFIRMARY MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF REIMBURSEMENT
Authorized Official - Prefix:
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:JORDAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-435-5037
Mailing Address - Street 1:PO BOX 2144
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36652-2144
Mailing Address - Country:US
Mailing Address - Phone:251-435-5037
Mailing Address - Fax:
Practice Address - Street 1:5 MOBILE INFIRMARY CIR
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36607-3513
Practice Address - Country:US
Practice Address - Phone:251-435-4700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-31
Last Update Date:2022-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL10420282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL395048OtherBLACK LUNG
ALHOS113HMedicaid
AL166826900OtherWORKER'S COMP
AL011877OtherBLUE CROSS
AL907158OtherHARVARD PILGRIMS
AL010024OtherBLUE CROSS
AL13953OtherHEALTHSPRING
AL00020482Medicaid
AL141969OtherEPOCH/HL
AL012211OtherBLUE CROSS
AL6120565OtherAETNA
AL751005OtherAL PSYCH
ALD36873OtherAMERIHEALTH
ALAL0144OtherACS HEALTH NET
AL751005OtherAL PSYCH
AL00020482Medicaid
AL13953OtherHEALTHSPRING