| Samford University Athletics | |
|
800 Lakeshore Dr Hanna Center, Rm 1105 Birmingham AL 35229-0001 | |
| (205) 726-2811 | |
| Not Available |
| Full Name | Samford University Athletics |
|---|---|
| Speciality | Clinic/center - Student Health |
| Location | 800 Lakeshore Dr, Birmingham, Alabama |
| Authorized Official Name and Position | Henry B. Brock (VP, BUSINESS & FINANCIAL AFFAIRS) |
| Authorized Official Contact | 2057262811 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Samford University Athletics 800 Lakeshore Dr Hanna Center, Rm 1105 Birmingham AL 35229-0001 Ph: (205) 726-2811 | Samford University Athletics 800 Lakeshore Dr Hanna Center, Rm 1105 Birmingham AL 35229-0001 Ph: (205) 726-2811 |
| NPI Number | 1699027680 |
|---|---|
| Provider Enumeration Date | 10/15/2012 |
| Last Update Date | 10/15/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699027680 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QS1000X | Clinic/center - Student Health | (* (Not Available)) | Primary |
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