Healthcare Provider Details

I. General information

NPI: 1760608269
Provider Name (Legal Business Name): MOBILE COUNTY BOARD OF HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2007
Last Update Date: 04/25/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

251 N BAYOU ST
MOBILE AL
36603-5827
US

IV. Provider business mailing address

251 N BAYOU ST P.O. BOX 2867
MOBILE AL
36603-5827
US

V. Phone/Fax

Practice location:
  • Phone: 251-690-8158
  • Fax: 251-690-8853
Mailing address:
  • Phone: 251-690-8158
  • Fax: 251-690-8853

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: CW JOHNSON
Title or Position: DIRECTOR OF BILLING
Credential:
Phone: 251-690-8158