Provider Demographics
NPI:1790896710
Name:MEDICAL WEST HOSPITAL AUTHORITY, AN AFFILIATE OF UAB HEALTH SYSTEM
Entity Type:Organization
Organization Name:MEDICAL WEST HOSPITAL AUTHORITY, AN AFFILIATE OF UAB HEALTH SYSTEM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:H
Authorized Official - Last Name:SLOCUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-481-7134
Mailing Address - Street 1:995 9TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:BESSEMER
Mailing Address - State:AL
Mailing Address - Zip Code:35022-4527
Mailing Address - Country:US
Mailing Address - Phone:205-481-7670
Mailing Address - Fax:205-481-7573
Practice Address - Street 1:995 9TH AVE SW
Practice Address - Street 2:
Practice Address - City:BESSEMER
Practice Address - State:AL
Practice Address - Zip Code:35022-4527
Practice Address - Country:US
Practice Address - Phone:205-481-7670
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2017-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL12816282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL010146OtherBLUE CROSS OF AL
AL5000003OtherMEDICARE COMPLETE
ALHOS0114HMedicaid
AL10184OtherHEALTHSPRINGS
AL312687OtherBLACK LUNG
AL5000003OtherUNITED HEALTH
AL10184OtherSENIORS FIRST
AL5000003OtherMEDICARE COMPLETE
AL5000003OtherMEDICARE COMPLETE