Provider Demographics
NPI:1821234246
Name:CHRIST HEALTH CENTER INC
Entity Type:Organization
Organization Name:CHRIST HEALTH CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:R
Authorized Official - Last Name:RECORD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-380-9455
Mailing Address - Street 1:5720 1ST AVE S
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35212-2522
Mailing Address - Country:US
Mailing Address - Phone:205-380-9455
Mailing Address - Fax:205-380-9459
Practice Address - Street 1:5720 1ST AVE S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35212-2522
Practice Address - Country:US
Practice Address - Phone:205-380-9455
Practice Address - Fax:205-380-9459
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-07
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALI39209Medicare UPIN