Provider Demographics
NPI:1730185455
Name:CUNNINGHAM PATHOLOGY, LLC
Entity type:Organization
Organization Name:CUNNINGHAM PATHOLOGY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-591-7999
Mailing Address - Street 1:924 MONTCLAIR RD
Mailing Address - Street 2:STE 200
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35213-1200
Mailing Address - Country:US
Mailing Address - Phone:205-591-7999
Mailing Address - Fax:205-591-5051
Practice Address - Street 1:924 MONTCLAIR RD
Practice Address - Street 2:STE 200
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35213-1200
Practice Address - Country:US
Practice Address - Phone:205-591-7999
Practice Address - Fax:205-591-5051
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CUNNINGHAM PATHOLOGY, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-06-27
Last Update Date:2009-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL09827291U00000X, 207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty
No291U00000XLaboratoriesClinical Medical LaboratoryGroup - Single Specialty