1962405910 NPI number — ALABAMA CARDIOVASCULAR GROUP, P.C.

Employer Identification Number (EIN)	:
Provider Organization Name (Legal Business Name)	:	ALABAMA CARDIOVASCULAR GROUP, P.C.
Provider Last Name (Legal Name)	:
Provider First Name	:
Provider Middle Name	:
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Provider Credential Text	:
Provider Gender Code	:

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	:
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NPI Number	:	1962405910
Entity Type Code	:	Organization
Replacement NPI	:
Last Update Date	:	07/09/2009
NPI Deactivation Reason Code	:
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Provider First Line Business Mailing Address	:	2700 10TH AVE S
Provider Second Line Business Mailing Address	:	STE 305
Provider Business Mailing Address City Name	:	BIRMINGHAM
Provider Business Mailing Address State Name	:	AL
Provider Business Mailing Address Postal Code	:	352051248
Provider Business Mailing Address Country Code	:	US
Provider Business Mailing Address Telephone Number	:	2059390139
Provider Business Mailing Address Fax Number	:	2059394997

Provider First Line Business Practice Location Address	:	2700 10TH AVE S
Provider Second Line Business Practice Location Address	:	STE 305
Provider Business Practice Location Address City Name	:	BIRMINGHAM
Provider Business Practice Location Address State Name	:	AL
Provider Business Practice Location Address Postal Code	:	352051248
Provider Business Practice Location Address Country Code	:	US
Provider Business Practice Location Address Telephone Number	:	2059390139
Provider Business Practice Location Address Fax Number	:	2059394997
Provider Enumeration Date	:	05/23/2005

Authorized Official Last Name	:	ARCINIEGAS
Authorized Official First Name	:	JOAQUIN
Authorized Official Middle Name	:	G.
Authorized Official Title or Position	:	PRESIDENT
Authorized Official Telephone Number	:	2059390139

• Taxonomy code: 174400000X .

• Identifier: J192 . This is a "BESSEMER SUITE 403" identifier , issued by the state of ( AL ) . This identifiers is of the category "".
• Identifier: J199 . This is a "ST. VINCENT'S LOCATION" identifier , issued by the state of ( AL ) . This identifiers is of the category "".
• Identifier: J193 . This is a "BESSEMER SUITE X01" identifier , issued by the state of ( AL ) . This identifiers is of the category "".
• Identifier: J196 . This is a "MEDICARE MCE" identifier , issued by the state of ( AL ) . This identifiers is of the category "".