Organization Name: | ALABAMA PROVIDENCE HEALTHCARE SERVICES |
NPI Number: | 1083043822 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TODD S. KENNEDY (PRESIDENT) |
Mailing Address: | 18 Rambo Dr Saraland |
State: | AL US |
Postal Code: | 365712147 |
Phone Number: | 2516757433 |
Fax Number: | 2516753470 |
NPI Enumeration Date: | 11/02/2013 |
NPI Last Update Date: | 09/28/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |