Provider Demographics
NPI:1104879741
Name:NORWOOD CLINIC INC
Entity type:Organization
Organization Name:NORWOOD CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CAO
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:PERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-250-6896
Mailing Address - Street 1:PO BOX 830230
Mailing Address - Street 2:ATTN CREDENTIALING
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35283-0230
Mailing Address - Country:US
Mailing Address - Phone:205-250-6000
Mailing Address - Fax:205-250-6848
Practice Address - Street 1:2022 BROOKWOOD MEDICAL CENTER DRIVE
Practice Address - Street 2:SUITE 510
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-6898
Practice Address - Country:US
Practice Address - Phone:205-250-6000
Practice Address - Fax:205-250-6848
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
Last Update Date:2015-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000800749Medicaid
ALI356Medicare PIN
ALH845Medicare PIN
ALI848Medicare PIN
ALD456Medicare PIN
AL000800749Medicaid
ALE508Medicare PIN
AL0236330001Medicare NSC
ALH726Medicare PIN
ALG438Medicare PIN
ALI847Medicare PIN