1902859291 NPI number — AFFINITY HOSPITAL LLC

Table of content: (NPI 1902859291)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902859291 NPI number — AFFINITY HOSPITAL LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AFFINITY HOSPITAL LLC
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:
6
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:
1902859291
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/28/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 830605
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:
35213
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
205-592-1200
Provider Business Mailing Address Fax Number:
205-592-5653

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
800 MONTCLAIR RD
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:
35213-1908
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-592-1200
Provider Business Practice Location Address Fax Number:
205-592-5653
Provider Enumeration Date:
05/18/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
LALOR
Authorized Official First Name:
PAULA
Authorized Official Middle Name:
M
Authorized Official Title or Position:
DIRECTOR/DELEGATED OFFICIAL
Authorized Official Telephone Number:
615-925-4565

Provider Taxonomy Codes

  • Taxonomy code: 314000000X , with the licence number:  12581 , 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)