Healthcare Provider Details

I. General information

NPI: 1073033551
Provider Name (Legal Business Name): CLARKE COUNTY HEALTH DEPT STD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2017
Last Update Date: 09/13/2024
Certification Date: 09/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22600 HIGHWAY 84
GROVE HILL AL
36451-5481
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: 251-275-3772
  • Fax: 251-275-8066
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