1518951599 NPI number — SOUTHERN MEDICAL & MOBILITY INC

Table of content: (NPI 1518951599)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518951599 NPI number — SOUTHERN MEDICAL & MOBILITY INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SOUTHERN MEDICAL & MOBILITY INC
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:
1518951599
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/20/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1416 W I65 SERVICE RD S
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MOBILE
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
36693-5100
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
251-633-4133
Provider Business Mailing Address Fax Number:
251-633-4575

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1416 W I65 SERVICE RD S
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MOBILE
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
36693-5100
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
251-633-4133
Provider Business Practice Location Address Fax Number:
251-633-4575
Provider Enumeration Date:
09/07/2005

Additional Information

Authorized Official

Authorized Official Last Name:
COMPTON
Authorized Official First Name:
HAROLD
Authorized Official Middle Name:
FREDERICK
Authorized Official Title or Position:
CEO/PRESIDENT
Authorized Official Telephone Number:
251-633-4133

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , with the licence number:  490041319 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 009987760 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 51507156 . This is a "BLUE CROSS ALABAMA" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 950633 . This is a "PRIME HEALTH" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 02726271 , issued by the state of ( MS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1230240 . This is a "HEALTHSPRING/SENIORS FIRS" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 1640450 . This is a "MEDICAID OF LA." identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".




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