OrganizationAlabama Providence Healthcare Services(<Unavail>)HospitalistAllopathic & Osteopathic PhysiciansPractice Address6801 Airport Blvd, Mobile, AL 36608-3709(251) 633-1000(251) 342-3949PECOS EnrollmentBased on the most recent information from CMS, provider Alabama Providence Healthcare Services does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 6 days ago.Profile DetailsProvider ID1639533383Provider TypeOrganizationFull NameAlabama Providence Healthcare ServicesOther Name<Unavail>SubpartNoEnumeration Date4/8/2016Last Updated4/8/2016Contact InformationPractice LocationPractice Address6801 Airport Blvd, Mobile, AL 36608-3709Phone(251) 633-1000FaxUnlisted FaxMailing LocationMailing AddressPO Box 850489, Mobile, AL 36685-0489Phone(251) 342-3949Fax(251) 631-3361Authorized OfficialNameKennedy, Todd (President)Phone(251) 633-1000Provider TaxonomiesCodeDescriptionLicenseCode208M00000XPrimaryDescriptionHospitalistAllopathic & Osteopathic PhysiciansLicenseUnlisted IssuerProvider IdentifiersIDDescriptionIssuerID156183DescriptionMedicaidIssuerUnlistedAlabama