Provider Demographics
NPI:1285449892
Name:BIRMINGHAM HEART CLINIC, PLLC
Entity type:Organization
Organization Name:BIRMINGHAM HEART CLINIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:BOBBY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROUSE
Authorized Official - Suffix:JR
Authorized Official - Credentials:CPA
Authorized Official - Phone:901-219-8656
Mailing Address - Street 1:100 PILOT MEDICAL DR STE 300
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35235-3412
Mailing Address - Country:US
Mailing Address - Phone:205-856-2284
Mailing Address - Fax:
Practice Address - Street 1:100 PILOT MEDICAL DR STE 300
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35235-3412
Practice Address - Country:US
Practice Address - Phone:205-856-2284
Practice Address - Fax:205-815-4777
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BIRMINGHAM HEART CLINIC, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-02-11
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WC3500XNursing Service ProvidersRegistered NurseCardiac RehabilitationGroup - Single Specialty