Provider Demographics
NPI:1053375204
Name:BHC - CENTERPOINT
Entity type:Organization
Organization Name:BHC - CENTERPOINT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERIM PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:M
Authorized Official - Last Name:BLACKBURN
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 1:9709 PARKWAY E
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35215-7853
Practice Address - Country:US
Practice Address - Phone:205-836-1199
Practice Address - Fax:205-836-0021
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BAPTIST HEALTH CENTERS, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-04-14
Last Update Date:2008-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL528903000Medicaid
AL528903000Medicaid