Provider Demographics
NPI:1861575144
Name:THE CHILDREN'S HOSPTIAL OF ALABAMA
Entity type:Organization
Organization Name:THE CHILDREN'S HOSPTIAL OF ALABAMA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:H
Authorized Official - Last Name:WALTON
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:205-638-9901
Mailing Address - Street 1:PO BOX 114070536
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35246-0536
Mailing Address - Country:US
Mailing Address - Phone:205-638-5600
Mailing Address - Fax:205-638-5623
Practice Address - Street 1:1940 ELMER J BISSELL RD
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35243-2941
Practice Address - Country:US
Practice Address - Phone:205-638-9100
Practice Address - Fax:205-638-9189
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL12129261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
46624OtherHEALTHSPRING ASC
011718OtherBC ASC
=========OtherALL OTHER