Provider Demographics
NPI:1679806798
Name:CHRIST HEALTH CENTER INC
Entity type:Organization
Organization Name:CHRIST HEALTH CENTER INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:REX
Authorized Official - Last Name:RECORD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-380-9455
Mailing Address - Street 1:5720 1ST AVE S
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35212-2522
Mailing Address - Country:US
Mailing Address - Phone:205-380-9435
Mailing Address - Fax:205-595-8685
Practice Address - Street 1:5804 1ST AVE S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35212-2524
Practice Address - Country:US
Practice Address - Phone:205-380-9435
Practice Address - Fax:205-595-8685
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-08
Last Update Date:2023-08-08
Deactivation Date:2023-07-17
Deactivation Code:
Reactivation Date:2023-08-04
Provider Licenses
StateLicense IDTaxonomies
333600000X
AL1133153336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL124857Medicaid
2121879OtherPK