Healthcare Provider Details

I. General information

NPI: 1598286809
Provider Name (Legal Business Name): ESCAMBIA COUNTY HEALTH DEPT (BREWTON) STD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2017
Last Update Date: 09/19/2024
Certification Date: 09/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1115 AZALEA PL
BREWTON AL
36426-1318
US

IV. Provider business mailing address

201 MONROE STREET SUITE 1600 RSA TOWER - CENTRALIZED BILLING UNIT
MONTGOMERY AL
36104-3721
US

V. Phone/Fax

Practice location:
  • Phone: 251-867-5765
  • Fax: 251-867-5179
Mailing address:
  • Phone: 334-206-7065
  • Fax: 334-206-3998

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: MS. ARNITA SHEPHERD
Title or Position: CBU DIRECTOR
Credential: MSW
Phone: 334-206-7065