Provider Demographics
NPI:1902346372
Name:HEMATOLOGY & ONCOLOGY ASSOCIATES OF ALABAMA LLC
Entity Type:Organization
Organization Name:HEMATOLOGY & ONCOLOGY ASSOCIATES OF ALABAMA LLC
Other - Org Name:HEMATOLOGY & ONCOLOGY ASSOCIATES OF ALABAMA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:YEILDING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-271-8541
Mailing Address - Street 1:PO BOX 131329
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35213-6329
Mailing Address - Country:US
Mailing Address - Phone:205-209-3514
Mailing Address - Fax:205-847-5172
Practice Address - Street 1:513 BROOKWOOD BLVD STE 65
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-6862
Practice Address - Country:US
Practice Address - Phone:205-209-3514
Practice Address - Fax:205-847-5172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-03
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
AL1147283336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2170231OtherPK