Provider Demographics
NPI:1053375154
Name:BHC - HELENA
Entity type:Organization
Organization Name:BHC - HELENA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:KICKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-715-5910
Mailing Address - Street 1:200 BEACON PKWY W
Mailing Address - Street 2:SUITE 330
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-3153
Mailing Address - Country:US
Mailing Address - Phone:205-715-5910
Mailing Address - Fax:205-715-5928
Practice Address - Street 1:270 VILLAGE PKWY
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:AL
Practice Address - Zip Code:35080-4040
Practice Address - Country:US
Practice Address - Phone:205-664-9430
Practice Address - Fax:205-664-1846
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALI228Medicare ID - Type Unspecified