Provider Demographics
NPI:1982653390
Name:HEALTH CARE AUTHORITY FOR BAPTIST HEALTH, AN AFFILIATE OF UABHS
Entity Type:Organization
Organization Name:HEALTH CARE AUTHORITY FOR BAPTIST HEALTH, AN AFFILIATE OF UABHS
Other - Org Name:MONTGOMERY PRIMARY MEDICINE ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:BRUTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-273-4447
Mailing Address - Street 1:2055 E SOUTH BLVD
Mailing Address - Street 2:SUITE 308
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36116-2003
Mailing Address - Country:US
Mailing Address - Phone:334-286-2390
Mailing Address - Fax:334-286-2397
Practice Address - Street 1:2055 E SOUTH BLVD
Practice Address - Street 2:SUITE 308
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36116-2003
Practice Address - Country:US
Practice Address - Phone:334-286-2390
Practice Address - Fax:334-286-2397
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-10
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL529929300Medicaid
AL1982653390OtherGROUP MEDICARE NPI
AL1982653390OtherGROUP MEDICARE NPI
AL529929300Medicaid
ALK874Medicare PIN