Organization
ST VINCENTS ST CLAIR LLC
Active
Parent organization
ST VINCENTS ST CLAIR LLC
Other names
St Clair Emergency Department
Organization subpart
Yes
Provider details
NPI number
Legal business name
ST VINCENTS ST CLAIR LLC
Authorized official
BRANDON WILLIAMS (CFO)
(205) 814-2104
Entity
Organization
Contact information
Practice address
2805 DR JOHN HAYNES DR, PELL CITY, AL 35125-1448
(205) 814-2104
(205) 814-2145
Mailing address
PO BOX 11407 LOCKBOX 1061, BIRMINGHAM, AL 35246-1061
(205) 437-6098
(205) 437-5998
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
167885300
DEPT OF LABOR (OWCP)
AL
01
—
311653
BLACK LUNG - DPT OF LABOR
AL
01
—
3901720
UNITEDHEALTHCARE OF AL
AL
05
—
529919640
—
AL
01
—
F856
BCBS GROUP PROVIDER #
AL
Enumeration date
09/29/2005
Last updated
09/06/2017
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