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General NPI Number Information
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NPI Number | 1215010772
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Entity Type | Organization
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Legal Business Name | STATE OF ALABAMA DEPARTMENT OF PUBLIC HEALTH
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Dates
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Enumeration Date | 10/20/2006
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Last Update Date | 09/16/2024
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Provider Practice Location Address
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Address Line | 39 BROWDER ST
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City | CLAYTON
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State | AL
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Zip | 36016-2079
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Country | US
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Telephone | 334-775-9044
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Fax | 334-775-9129
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Provider Business Mailing Address
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Address Line | 201 MONROE ST THE RSA TOWER, SUITE 1200
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City | MONTGOMERY
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State | AL
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Zip | 36104-3830
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Country | US
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Telephone | 334-206-5341
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Fax | 334-206-5985
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Authorized Official
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Title or Position | STATE HOME CARE DIRECTORE
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Name | GROVER T WEDGEWORTH
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Credential |
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Telephone | 334-206-5341
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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