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NPI Code Detail

MEDICARE: STATE OF ALABAMA DEPARTMENT OF PUBLIC HEALTH

MEDICARE: STATE OF ALABAMA DEPARTMENT OF PUBLIC HEALTH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251E00000XHome Health Agency

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1CHI9911AOTHERALBIOMONITORING PROVIDER #

General Provider Information

NPI Number : 1336223965
Entity Type Code : Organization
Provider Name (Legal Business Name) : STATE OF ALABAMA DEPARTMENT OF PUBLIC HEALTH
Provider Business Mailing Address
First Line : 201 MONROE ST
Second Line : THE RSA TOWER, SUITE 1200
City : MONTGOMERY
State : AL
Zip : 36104-3735
Country : US
Telephone Number : 334-206-5341
Fax Number : 334-206-5724
Provider Business Practice Location Address
First Line : 301 HEALTH CENTER DR
Second Line :
City : CLANTON
State : AL
Zip : 35045-2349
Country : US
Telephone Number : 205-755-8407
Fax Number : 205-755-8432
Authorized Official
Title or Position : STATE HOME CARE DIRECTOR
Name : GROVER T WEDGEWORTH
Credential :
Telephone Number : 334-206-5341
Provider Enumeration Date : 10/24/2006
Last Update Date : 07/26/2007

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Directions to “STATE OF ALABAMA DEPARTMENT OF PUBLIC HEALTH ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.