Provider Demographics
NPI:1881086890
Name:MEDNET WEST, INC.
Entity type:Organization
Organization Name:MEDNET WEST, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TINA
Authorized Official - Middle Name:
Authorized Official - Last Name:STEVENSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-553-4661
Mailing Address - Street 1:3816 PALISADES DR STE B
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35405-3451
Mailing Address - Country:US
Mailing Address - Phone:205-553-4661
Mailing Address - Fax:205-553-2191
Practice Address - Street 1:3816 PALISADES DR STE B
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35405-3451
Practice Address - Country:US
Practice Address - Phone:205-553-4661
Practice Address - Fax:205-553-2191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-27
Last Update Date:2015-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management