Organization Name: | EDWARDS LAKE MEDICAL CENTER LLC |
NPI Number: | 1043321300 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JACKI BAILEY (BILLING MGR) |
Mailing Address: | 3240 Edwards Lake Pkwy Suite 204 Birmingham |
State: | AL US |
Postal Code: | 352353117 |
Phone Number: | 2059491414 |
Fax Number: | 2059491415 |
NPI Enumeration Date: | 08/31/2006 |
NPI Last Update Date: | 12/05/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 00013482 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AL |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |