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Alabama Providence Healthcare Services

Family Medicine in Saraland, AL. Organization (NPI-2).

NPI number1083043822
StatusActive
Last updated in NPPESSep 28, 2015

Details

NPI
1083043822
Entity type
Organization (NPI-2)
Legal business name
Alabama Providence Healthcare Services
Organization subpart
Yes
Enumeration date
Nov 2, 2013
Last updated
Sep 28, 2015

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine––Yes
208D00000X General Practice––

Other names

  • Providence Medical Group (Other Name)

Practice location

18 Rambo Dr
Saraland, AL 36571-2147

Phone 251-675-7433 · Fax 251-675-3470

Mailing address

Po Box 850489
Mobile, AL 36685-0489

Phone 251-342-3949 · Fax 251-631-3361

Authorized official

Todd S. Kennedy
President
2516331660

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