Provider Demographics
NPI:1841613452
Name:SHELBY BAPTIST HEALTH CENTER CALERA
Entity Type:Organization
Organization Name:SHELBY BAPTIST HEALTH CENTER CALERA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:CLAYTON
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:BARNETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-668-0626
Mailing Address - Street 1:206 HIGHWAY 304
Mailing Address - Street 2:
Mailing Address - City:CALERA
Mailing Address - State:AL
Mailing Address - Zip Code:35040-5540
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:206 HIGHWAY 304
Practice Address - Street 2:
Practice Address - City:CALERA
Practice Address - State:AL
Practice Address - Zip Code:35040-5540
Practice Address - Country:US
Practice Address - Phone:205-668-0626
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-03
Last Update Date:2014-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL29979261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL131577Medicaid
ALA97856Medicare UPIN