Provider Demographics
NPI:1609446087
Name:ALABAMA PROVIDENCE HEALTHCARE SERVICES
Entity Type:Organization
Organization Name:ALABAMA PROVIDENCE HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ENROLLMENT MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MIRANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:HEMM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-450-6004
Mailing Address - Street 1:6701 AIRPORT BLVD STE D436
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36608-6705
Mailing Address - Country:US
Mailing Address - Phone:251-266-1987
Mailing Address - Fax:
Practice Address - Street 1:6701 AIRPORT BLVD STE D436
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-6705
Practice Address - Country:US
Practice Address - Phone:251-266-1987
Practice Address - Fax:251-266-2070
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALABAMA PROVIDENCE HEALTHCARE SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-06-29
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Multi-Specialty