Provider Demographics
NPI:1982793543
Name:NORTHPORT MEDICAL CENTER
Entity Type:Organization
Organization Name:NORTHPORT MEDICAL CENTER
Other - Org Name:NORTHPORT MEDICAL CENTER - REHAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PATIENT ACCOUNTS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KERI
Authorized Official - Middle Name:H
Authorized Official - Last Name:HINDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-759-7378
Mailing Address - Street 1:809 UNIVERSITY BLVD E
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35401-2029
Mailing Address - Country:US
Mailing Address - Phone:205-759-7190
Mailing Address - Fax:205-759-6397
Practice Address - Street 1:2700 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:NORTHPORT
Practice Address - State:AL
Practice Address - Zip Code:35476-3360
Practice Address - Country:US
Practice Address - Phone:205-343-8500
Practice Address - Fax:205-759-6397
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-12
Last Update Date:2021-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL06972273Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL01T145Medicare Oscar/Certification