Organization
ALABAMA CARE PLAN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRAD ROLLOW (SECRETARY-TREASURER)
(205) 558-7401
Entity
Organization
Contact information
Practice address
417 20TH ST N, SUITE 1100, BIRMINGHAM, AL 35203-3203
(205) 558-7641
(205) 449-7626
Mailing address
417 20TH ST N, SUITE 1100, BIRMINGHAM, AL 35203-3203
(205) 558-7641
(205) 449-7626
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
MEDICAID RCO
AL
Other
Enumeration date
02/26/2015
Last updated
02/26/2015
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