1588621296 NPI number — RADIOLOGY OF HUNTSVILLE, P.C.

Table of content: (NPI 1588621296)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588621296 NPI number — RADIOLOGY OF HUNTSVILLE, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RADIOLOGY OF HUNTSVILLE, P.C.
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:
Provider Other Organization Name Type Code:
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:
1588621296
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/20/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2006 FRANKLIN ST., SE
Provider Second Line Business Mailing Address:
SUITE 200
Provider Business Mailing Address City Name:
HUNTSVILLE
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35801-4537
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
256-539-0457
Provider Business Mailing Address Fax Number:
256-539-5827

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2006 FRANKLIN ST SE
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
HUNTSVILLE
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35801-4537
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
256-539-0457
Provider Business Practice Location Address Fax Number:
256-539-5827
Provider Enumeration Date:
04/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MCCOWN
Authorized Official First Name:
BRANDY
Authorized Official Middle Name:
C.
Authorized Official Title or Position:
CREDENTIALING SPECIALIST
Authorized Official Telephone Number:
256-713-0647

Provider Taxonomy Codes

  • Taxonomy code: 2085R0202X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 890-51544 . This is a "BCBS AL" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 243282 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 243356 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 512-34996 . This is a "BCBS AL" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 512-35104 . This is a "BCBS AL" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: Q029819 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 200343 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 266246 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 512-35881 . This is a "BCBS AL" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 201214 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 243302 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 245499 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 511-92546 . This is a "BCBS AL" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 890-44275 . This is a "BCBS AL" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 199106 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 511-92547 . This is a "BCBS AL" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 200976 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 201273 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 511-92545 . This is a "BCBS AL" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 512-08098 . This is a "BCBS AL" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".




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