Healthcare Provider Details

I. General information

NPI: 1972698199
Provider Name (Legal Business Name): MOBILE COUNTY BOARD OF HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 07/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1080 RESERVATION RD
MOUNT VERNON AL
36560
US

IV. Provider business mailing address

PO BOX 2867
MOBILE AL
36652-2867
US

V. Phone/Fax

Practice location:
  • Phone: 251-829-9884
  • Fax: 251-866-9121
Mailing address:
  • Phone: 251-690-8158
  • Fax: 251-690-8853

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: MRS. SUSAN STIEGLER
Title or Position: DIRECTOR FAMILY HEALTH CLINICAL SER
Credential:
Phone: 251-690-8833