Provider Demographics
NPI:1821363268
Name:IMC - WOMENS HEALTH ALLIANCE OF MOBILE LLC
Entity Type:Organization
Organization Name:IMC - WOMENS HEALTH ALLIANCE OF MOBILE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT OF FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:PALAZZO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-435-1361
Mailing Address - Street 1:1720 SPRING HILL AVE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36604-1410
Mailing Address - Country:US
Mailing Address - Phone:251-435-7700
Mailing Address - Fax:251-435-7702
Practice Address - Street 1:1720 SPRING HILL AVE
Practice Address - Street 2:SUITE 400
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36604-1410
Practice Address - Country:US
Practice Address - Phone:251-435-7700
Practice Address - Fax:251-435-7702
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-19
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty