Healthcare Provider Details

I. General information

NPI: 1295878973
Provider Name (Legal Business Name): HENRY COUNTY HEALTH DEPT-ABBEVILLE ADULT IMMUN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2007
Last Update Date: 09/17/2024
Certification Date: 09/17/2024
Deactivation Date: 07/17/2007
Reactivation Date: 03/08/2021

III. Provider practice location address

PO BOX 86
ABBEVILLE AL
36310-0086
US

IV. Provider business mailing address

PO BOX 86
ABBEVILLE AL
36310-0086
US

V. Phone/Fax

Practice location:
  • Phone: 334-585-2660
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VIII. Authorized Official

Name: REGINA L PATTERSON
Title or Position: DIRECTOR OF HEALTH SYSTEMS
Credential:
Phone: 334-206-5061