Provider Demographics
NPI:1154435824
Name:UNIVERSITY OF ALABAMA AT BIRMINGHAM
Entity type:Organization
Organization Name:UNIVERSITY OF ALABAMA AT BIRMINGHAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO UAB HEALTH SYSTEM
Authorized Official - Prefix:MR
Authorized Official - First Name:REID
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-731-9770
Mailing Address - Street 1:619 19TH ST S
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35249-0001
Mailing Address - Country:US
Mailing Address - Phone:205-934-6249
Mailing Address - Fax:205-975-9838
Practice Address - Street 1:619 19TH ST S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35249-0001
Practice Address - Country:US
Practice Address - Phone:205-934-6249
Practice Address - Fax:205-975-9838
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-18
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL11831282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL010-055OtherBLUE CROSS OF ALABAMA
ALHOS0033Medicaid
MS00020395Medicaid
AL010033Medicare Oscar/Certification