Healthcare Provider Details

I. General information

NPI: 1639693443
Provider Name (Legal Business Name): ALABAMA DEPARTMENT OF PUBLIC HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2017
Last Update Date: 08/02/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 CORPORATE DR
OPELIKA AL
36801-6861
US

IV. Provider business mailing address

201 MONROE ST STE 1200
MONTGOMERY AL
36104-3830
US

V. Phone/Fax

Practice location:
  • Phone: 334-745-5765
  • Fax: 334-745-9825
Mailing address:
  • Phone: 334-206-5677
  • Fax: 334-206-5985

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: THOMAS M MILLER
Title or Position: STATE HEALTH OFFICER
Credential:
Phone: 334-206-5200