Organization
GREATER AL HEALTH NETWORK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BECKY HENDERSON (PROGRAM DIRECTOR)
(205) 345-5205
Entity
Organization
Contact information
Practice address
921 PROFESSIONAL PLZ, TUSCALOOSA, AL 35401-7418
(205) 345-1905
Mailing address
921 PROFESSIONAL PLZ, TUSCALOOSA, AL 35401-7418
(205) 345-1905
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
580500004
—
AL
Enumeration date
11/12/2013
Last updated
11/12/2013
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