OrganizationProvidence Hospital(<Unavail>)HospitalistAllopathic & Osteopathic PhysiciansPractice Address6801 Airport Blvd, Hospitalist Dept., Mobile, AL 36608-3709(251) 639-5775(251) 342-3949PECOS EnrollmentBased on the most recent information from CMS, provider Providence Hospital 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 5 days ago.Profile DetailsProvider ID1871922971Provider TypeOrganizationFull NameProvidence HospitalOther Name<Unavail>SubpartYesEnumeration Date11/8/2013Last Updated9/28/2015Contact InformationPractice LocationPractice Address6801 Airport Blvd, Hospitalist Dept., Mobile, AL 36608-3709Phone(251) 639-5775Fax(251) 631-3581Mailing LocationMailing AddressPO Box 850489, Mobile, AL 36685-0489Phone(251) 342-3949Fax(251) 631-3361Authorized OfficialNameKennedy, Todd S. (President)Phone(251) 633-1660Provider TaxonomiesCodeDescriptionLicenseCode208M00000XPrimaryDescriptionHospitalistAllopathic & Osteopathic PhysiciansLicenseUnlisted Issuer