1326172156 NPI number — ST. VINCENT'S EAST

Table of content: (NPI 1326172156)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326172156 NPI number — ST. VINCENT'S EAST

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ST. VINCENT'S EAST
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ST. VINCENT'S EAST CRNA'S
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1326172156
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/06/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
50 MEDICAL CENTER EAST DRIVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BIRMINGHAM
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35235-3401
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
205-838-3343
Provider Business Mailing Address Fax Number:
205-838-6119

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
50 MEDICAL CENTER EAST DRIVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BIRMINGHAM
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35235-3401
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-838-3343
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/15/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
WILLIAMS
Authorized Official First Name:
BRANDON
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
205-838-3718

Provider Taxonomy Codes

  • Taxonomy code: 367500000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 559900150 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: C802 . This is a "MCARE PART B" identifier . This identifiers is of the category "OTHER".