Organization
UNIVERSITY OF ALABAMA AT BIRMINGHAM
Active
Other names
COMMUNITY HLTH SVCS-FAMILY PHY
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER PETERSON PHARMD (DIRECTOR OF AMBULATORY OPERATI)
(205) 934-7862
Entity
Organization
Contact information
Practice address
930 20TH ST S, BIRMINGHAM, AL 35205-2610
(205) 975-7792
(205) 975-6962
Mailing address
1201 11TH AVE S, 3RD FLOOR PHARMACY, BIRMINGHAM, AL 35205-3410
(205) 930-7585
(205) 930-7587
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
Primary
111175
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100010012
—
AL
01
—
1993075
PK
—
Enumeration date
09/21/2006
Last updated
12/12/2014
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