Provider Demographics
NPI:1588928618
Name:PRINCETON BAPTIST MEDICAL CENTER
Entity type:Organization
Organization Name:PRINCETON BAPTIST MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE MICU
Authorized Official - Prefix:MR
Authorized Official - First Name:COREY
Authorized Official - Middle Name:JUSTIN
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:205-783-3100
Mailing Address - Street 1:187 LORRIN LN
Mailing Address - Street 2:
Mailing Address - City:STERRETT
Mailing Address - State:AL
Mailing Address - Zip Code:35147-9528
Mailing Address - Country:US
Mailing Address - Phone:205-260-2627
Mailing Address - Fax:
Practice Address - Street 1:187 LORRIN LN
Practice Address - Street 2:
Practice Address - City:STERRETT
Practice Address - State:AL
Practice Address - Zip Code:35147-9528
Practice Address - Country:US
Practice Address - Phone:205-260-2627
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-04
Last Update Date:2012-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-130710282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital