Provider Demographics
NPI:1184700288
Name:THE CHILDREN'S HOSPITAL OF ALABAMA
Entity type:Organization
Organization Name:THE CHILDREN'S HOSPITAL OF ALABAMA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:H
Authorized Official - Last Name:WALTON
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:205-939-9073
Mailing Address - Street 1:1600 7TH AVE S
Mailing Address - Street 2:DEPT. OF HEARING & SPEECH
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35233-1711
Mailing Address - Country:US
Mailing Address - Phone:205-939-9100
Mailing Address - Fax:205-939-9189
Practice Address - Street 1:1600 7TH AVE S
Practice Address - Street 2:DEPT. OF HEARING & SPEECH
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-1711
Practice Address - Country:US
Practice Address - Phone:205-939-9100
Practice Address - Fax:205-939-9189
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL11819332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51523680OtherBCBS
AL=========024OtherTRICARE