Provider Demographics
NPI:1578796496
Name:COMMUNITY PRESBYTERIAN CENTER
Entity Type:Organization
Organization Name:COMMUNITY PRESBYTERIAN CENTER
Other - Org Name:PROJECT H.E.L.P. USA/MRC
Other - Org Type:Other Name
Authorized Official - Title/Position:MEDICAL SERVICES DIRECTOR/PI
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:R
Authorized Official - Last Name:ELLISON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:205-368-3733
Mailing Address - Street 1:BOX 11434
Mailing Address - Street 2:BRUNO-SMITHFIELD COMMUNITY HEALTH CENTER
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35204-1434
Mailing Address - Country:US
Mailing Address - Phone:205-368-3733
Mailing Address - Fax:
Practice Address - Street 1:421 REVEREND ABRAHAM WOODS JR BLVD
Practice Address - Street 2:BRUNO-SMITHFIELD COMMUNTY HEALTH CENTER
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35204-3715
Practice Address - Country:US
Practice Address - Phone:205-368-3733
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-26
Last Update Date:2009-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable