# PROVIDENCE HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1952390643
- **Authorized official:** MR. TODD S. KENNEDY (PRESIDENT AND CEO)
- **Authorized official phone:** (251) 633-1663

## Contact information

- **Practice address:** 6801 AIRPORT BLVD, MOBILE, AL 36608-3709
- **Practice address phone:** (251) 633-1600
- **Practice address fax:** (251) 633-1679
- **Mailing address:** PO BOX 851537, MOBILE, AL 36685-1537
- **Mailing address phone:** (251) 633-1600
- **Mailing address fax:** (251) 633-1679

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QL0400X | Lithotripsy Clinic/Center | — | NULL | — |
| 282N00000X | General Acute Care Hospital | 10385 | AL | Yes |

## Other

- **Enumeration date:** 10/17/2005
- **Last updated:** 09/29/2015