Provider Demographics
NPI:1740021476
Name:MOBILE INFIRMARY ASSOCIATION
Entity type:Organization
Organization Name:MOBILE INFIRMARY ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, REIMBURSEMENT
Authorized Official - Prefix:
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:W
Authorized Official - Last Name:REDFOOT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-435-2290
Mailing Address - Street 1:PO BOX 2226
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36652-2226
Mailing Address - Country:US
Mailing Address - Phone:251-435-2425
Mailing Address - Fax:
Practice Address - Street 1:1720 SPRING HILL AVE STE 401
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36604-1410
Practice Address - Country:US
Practice Address - Phone:251-210-3250
Practice Address - Fax:251-210-3251
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MOBILE INFIRMARY ASSOCIATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-06-05
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty