Provider Demographics
NPI:1609945906
Name:THE UNIVERSITY OF ALABAMA AT BIRMINGHAM
Entity Type:Organization
Organization Name:THE UNIVERSITY OF ALABAMA AT BIRMINGHAM
Other - Org Name:UAB HOSPITALIST SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-284-5211
Mailing Address - Street 1:4371 NARROW LANE RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36116-2971
Mailing Address - Country:US
Mailing Address - Phone:334-284-5211
Mailing Address - Fax:334-386-0259
Practice Address - Street 1:4371 NARROW LANE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36116-2971
Practice Address - Country:US
Practice Address - Phone:334-284-5211
Practice Address - Fax:334-386-0259
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2008-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALG353OtherBCBS
AL528301030Medicaid
AL528301030Medicaid
ALDD7765Medicare PIN