Provider Demographics
NPI:1962405910
Name:ALABAMA CARDIOVASCULAR GROUP, P.C.
Entity type:Organization
Organization Name:ALABAMA CARDIOVASCULAR GROUP, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOAQUIN
Authorized Official - Middle Name:G
Authorized Official - Last Name:ARCINIEGAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-939-0139
Mailing Address - Street 1:2700 10TH AVE S
Mailing Address - Street 2:STE 305
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205-1248
Mailing Address - Country:US
Mailing Address - Phone:205-939-0139
Mailing Address - Fax:205-939-4997
Practice Address - Street 1:2700 10TH AVE S
Practice Address - Street 2:STE 305
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35205-1248
Practice Address - Country:US
Practice Address - Phone:205-939-0139
Practice Address - Fax:205-939-4997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-23
Last Update Date:2015-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALJ192Medicare ID - Type UnspecifiedBESSEMER SUITE 403
ALJ193Medicare ID - Type UnspecifiedBESSEMER SUITE X01
ALJ196OtherMEDICARE MCE
ALJ199Medicare ID - Type UnspecifiedST. VINCENT'S LOCATION