Provider Demographics
NPI:1194958124
Name:CENTER FOR ADULT MEDICINE & HYPERTENSION, PC
Entity type:Organization
Organization Name:CENTER FOR ADULT MEDICINE & HYPERTENSION, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:VIVIAN
Authorized Official - Middle Name:ABOKO-COLE
Authorized Official - Last Name:HICKS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:256-533-3525
Mailing Address - Street 1:411 ENGLE DR SW
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-5119
Mailing Address - Country:US
Mailing Address - Phone:256-533-3525
Mailing Address - Fax:
Practice Address - Street 1:411 ENGLE DR SW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-5119
Practice Address - Country:US
Practice Address - Phone:256-533-3525
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-25
Last Update Date:2009-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care