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Organization

EASTER SEALS ALABAMA, INC. EASTER SEALS WEST ALABAMA

Active
Other names
Easter Seals West Alabama
Organization subpart
No

Provider details

NPI number
Authorized official
RONNY B. JOHNSTON (ADMINISTRATOR)
(205) 759-1211
Entity
Organization

Contact information

Practice address
1110 DR. EDWARD HILLARD DRIVE, TUSCALOOSA, AL 35401-3207
(205) 759-1211
(205) 349-1162
Mailing address
PO BOX 2817, TUSCALOOSA, AL 35403-2817
(205) 759-1211
(205) 349-1162

Taxonomy

Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
12008
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
010-175
BLUE CROSS & BLUE SHIELD
AL
01
51077985
BLUE CROSS & BLUE SHIELD
AL
01
515-31066
BLUE CROSS & BLUE SHIELD
AL
01
51515014
BLUE CROSS & BLUE SHIELD
AL
01
51531482
BLUE CROSS & BLUE SHIELD
AL
01
51533901
BLUE CROSS & BLUE SHIELD
AL
05
529101420
AL
Enumeration date
09/14/2006
Last updated
07/21/2021
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