Provider Demographics
NPI:1659628683
Name:THE CHILDREN'S HOSPITAL OF ALABAMA
Entity Type:Organization
Organization Name:THE CHILDREN'S HOSPITAL OF ALABAMA
Other - Org Name:CHILDRENS HOSPITAL OUTPATIENT PHARMCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:WALTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-638-9901
Mailing Address - Street 1:1600 7TH AVE S
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35233-1711
Mailing Address - Country:US
Mailing Address - Phone:205-638-9714
Mailing Address - Fax:205-638-9934
Practice Address - Street 1:1600 7TH AVE S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-1711
Practice Address - Country:US
Practice Address - Phone:205-638-9714
Practice Address - Fax:205-638-9934
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE CHILDREN'S HOSPITAL OF ALABAMA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-08-09
Last Update Date:2020-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL113938282NC2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC2000XHospitalsGeneral Acute Care HospitalChildren