Organization
UNIVERSITY OF SOUTH ALABAMA HEALTH SERVICES FOUNDATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BECKY S. TATE (CHIEF EXECUTIVE OFFICER)
(251) 470-5842
Entity
Organization
Contact information
Practice address
2451 FILLINGIM ST, MASTIN BLDG. 617, MOBILE, AL 36617-2238
(251) 470-5842
(251) 470-5809
Mailing address
PO BOX 40480, MOBILE, AL 36640-0480
(251) 470-5842
(251) 470-5809
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1445061
—
LA
01
—
F882
BCBS COMMON PAY #
AL
05
—
GSD600
—
AL
Enumeration date
05/19/2006
Last updated
04/20/2008
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