Basic Information
| Provider Information | |||||||||
| NPI: | 1174581805 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | STERLING EMERGENCY SERVICES OF ALABAMA, INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 863535 | ||||||||
| Address2: | |||||||||
| City: | ORLANDO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 328863535 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9048051300 | ||||||||
| FaxNumber: | 9048051302 | ||||||||
| Practice Location | |||||||||
| Address1: | 401 MEDICAL PARK DR | ||||||||
| Address2: | |||||||||
| City: | ATMORE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 365023006 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2513682500 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/03/2006 | ||||||||
| LastUpdateDate: | 07/23/2008 | ||||||||
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| AuthorizedOfficialLastName: | BUNKER | ||||||||
| AuthorizedOfficialFirstName: | ROBERT | ||||||||
| AuthorizedOfficialMiddleName: | J | ||||||||
| AuthorizedOfficialTitleorPosition: | CHAIRMAN/PRESIDENT/CEO | ||||||||
| AuthorizedOfficialTelephone: | 9048051300 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | N | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical | 363L00000X | N | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 207P00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | 529908660 | 05 | AL | MEDICAID | 912737200 | 01 | FL | FLORIDA MEDICAID | OTHER | 912737200 | 01 | AL | DEPT OF LABOR | OTHER |