Provider Demographics
NPI:1730658261
Name:HAJEK, HENRY
Entity Type:Individual
Prefix:MR
First Name:HENRY
Middle Name:
Last Name:HAJEK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6130 OLD GREENSBORO RD
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35405-5923
Mailing Address - Country:US
Mailing Address - Phone:205-394-6917
Mailing Address - Fax:205-278-6748
Practice Address - Street 1:6130 OLD GREENSBORO RD
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35405-5923
Practice Address - Country:US
Practice Address - Phone:205-394-6917
Practice Address - Fax:205-278-6748
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-14
Last Update Date:2018-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALR008243707332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies