Provider Demographics
NPI:1427066307
Name:STATE OF ALABAMA DEPT OF FINANCE
Entity type:Organization
Organization Name:STATE OF ALABAMA DEPT OF FINANCE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:SAM
Authorized Official - Middle Name:J
Authorized Official - Last Name:LEVIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-662-6700
Mailing Address - Street 1:PO BOX 1090
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:AL
Mailing Address - Zip Code:36560-1090
Mailing Address - Country:US
Mailing Address - Phone:251-662-6700
Mailing Address - Fax:251-829-5385
Practice Address - Street 1:725 EAST COY SMITH HWY
Practice Address - Street 2:
Practice Address - City:MT VERNON
Practice Address - State:AL
Practice Address - Zip Code:36560
Practice Address - Country:US
Practice Address - Phone:251-662-6700
Practice Address - Fax:251-829-5385
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-04
Last Update Date:2010-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL283Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL01-4008Medicare Oscar/Certification
ALC954Medicare PIN