Provider Demographics
NPI:1356377576
Name:UNIVERSITY OF ALABAMA HEALTH SERVICES FOUNDATION, PC
Entity type:Organization
Organization Name:UNIVERSITY OF ALABAMA HEALTH SERVICES FOUNDATION, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ASSOCIATE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:HALBROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-975-8220
Mailing Address - Street 1:PO BOX 55823
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35255-5823
Mailing Address - Country:US
Mailing Address - Phone:205-934-3795
Mailing Address - Fax:
Practice Address - Street 1:1600 7TH AVE S
Practice Address - Street 2:
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:205-975-2499
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-23
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty