Healthcare Provider Details

I. General information

NPI: 1659914190
Provider Name (Legal Business Name): ALABAMA DEPT OF PUBLIC HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2019
Last Update Date: 09/19/2024
Certification Date: 09/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3060 MOBILE HWY
MONTGOMERY AL
36108-4027
US

IV. Provider business mailing address

201 MONROE ST STE 1600
MONTGOMERY AL
36104-3721
US

V. Phone/Fax

Practice location:
  • Phone: 334-293-6400
  • Fax: 334-293-6410
Mailing address:
  • Phone: 334-206-7065
  • Fax: 334-206-3715

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: ARNITA L. SHEPHERD
Title or Position: DIRECTOR, CENTRALIZED BILLING UNIT
Credential:
Phone: 334-206-7065