Basic Information
| Provider Information | |||||||||
| NPI: | 1982612073 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | UAHSF NEWBORN NURSERY | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 55823 | ||||||||
| Address2: | |||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352555823 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2059962244 | ||||||||
| FaxNumber: | 2059962254 | ||||||||
| Practice Location | |||||||||
| Address1: | 525 NHB | ||||||||
| Address2: | 619 SO 19TH STREET | ||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352490001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2059962244 | ||||||||
| FaxNumber: | 2059962254 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/04/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | GENTRY | ||||||||
| AuthorizedOfficialFirstName: | JAN | ||||||||
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| AuthorizedOfficialTitleorPosition: | DIRECTOR OF PROFESSIONAL SERVICES | ||||||||
| AuthorizedOfficialTelephone: | 2059758850 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.