Provider Demographics
NPI:1740375724
Name:ALABASTER PEDIATRICS LLC
Entity type:Organization
Organization Name:ALABASTER PEDIATRICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:BOHANNON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-663-5547
Mailing Address - Street 1:1004 1ST ST N STE 370
Mailing Address - Street 2:
Mailing Address - City:ALABASTER
Mailing Address - State:AL
Mailing Address - Zip Code:35007-8605
Mailing Address - Country:US
Mailing Address - Phone:205-663-5547
Mailing Address - Fax:205-663-1990
Practice Address - Street 1:1004 1ST ST N STE 370
Practice Address - Street 2:
Practice Address - City:ALABASTER
Practice Address - State:AL
Practice Address - Zip Code:35007-8605
Practice Address - Country:US
Practice Address - Phone:205-663-5547
Practice Address - Fax:205-663-5547
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty