Provider Demographics
NPI:1720465461
Name:MOBILE INFIRMARY ASSOCIATION
Entity type:Organization
Organization Name:MOBILE INFIRMARY ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:BREWINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:251-435-2400
Mailing Address - Street 1:PO BOX 297
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:AL
Mailing Address - Zip Code:36559-0297
Mailing Address - Country:US
Mailing Address - Phone:251-591-6240
Mailing Address - Fax:
Practice Address - Street 1:5 MOBILE INFIRMARY CIR
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36607-3513
Practice Address - Country:US
Practice Address - Phone:251-435-2400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-01
Last Update Date:2015-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-054817282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital