Provider Demographics
NPI:1760586325
Name:NORTHPORT MEDICAL CENTER
Entity Type:Organization
Organization Name:NORTHPORT MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PATIENT ACCOUNTS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KERI
Authorized Official - Middle Name:H
Authorized Official - Last Name:HINDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-759-7378
Mailing Address - Street 1:809 UNIVERSITY BLVD E
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35401-2029
Mailing Address - Country:US
Mailing Address - Phone:205-759-7190
Mailing Address - Fax:205-759-6397
Practice Address - Street 1:2700 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:NORTHPORT
Practice Address - State:AL
Practice Address - Zip Code:35476-3360
Practice Address - Country:US
Practice Address - Phone:205-343-8500
Practice Address - Fax:205-759-6397
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-12
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL010150OtherBCBS
AL9310OtherHEALTHSPRINGS
ALA3540103OtherUNITED HEALTHCARE
ALCN1406OtherRAILROAD MEDICARE 2
ALHOS0145HMedicaid
MS00220565Medicaid
AL510C912OtherBLUE SHIELD
ALCA6681OtherRAILROAD MEDICARE
AL559000080Medicaid
AL010145Medicare Oscar/Certification
ALC912 / K519Medicare PIN