Provider Demographics
NPI:1184978603
Name:UNIVERSITY OF WEST ALABAMA
Entity type:Organization
Organization Name:UNIVERSITY OF WEST ALABAMA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT/FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:T.
Authorized Official - Middle Name:RAIFORD
Authorized Official - Last Name:NOLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-652-3536
Mailing Address - Street 1:100 U.S. 11
Mailing Address - Street 2:STATION 14 UWA, ROOM 216
Mailing Address - City:LIVINGSTON
Mailing Address - State:AL
Mailing Address - Zip Code:35470
Mailing Address - Country:US
Mailing Address - Phone:205-652-3714
Mailing Address - Fax:205-652-3799
Practice Address - Street 1:100 U.S. 11
Practice Address - Street 2:STATION 14 UWA, ROOM 216
Practice Address - City:LIVINGSTON
Practice Address - State:AL
Practice Address - Zip Code:35470
Practice Address - Country:US
Practice Address - Phone:205-652-3714
Practice Address - Fax:205-652-3799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-06
Last Update Date:2012-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health