Provider Demographics
NPI:1538610241
Name:ST. VINCENT'S BLOUNT
Entity type:Organization
Organization Name:ST. VINCENT'S BLOUNT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-838-3766
Mailing Address - Street 1:180 MEDICAL ST
Mailing Address - Street 2:
Mailing Address - City:SNEAD
Mailing Address - State:AL
Mailing Address - Zip Code:35952-6468
Mailing Address - Country:US
Mailing Address - Phone:205-274-3010
Mailing Address - Fax:
Practice Address - Street 1:50 MEDICAL PARK DR E
Practice Address - Street 2:BLDG 46, STE 310, FINANCE
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35235-3401
Practice Address - Country:US
Practice Address - Phone:205-838-5286
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST. VINCENT'S HEALTH SYSTEM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-10-18
Last Update Date:2017-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty