1518292218 NPI number — ST. CLAIR COUNTY

Table of content: (NPI 1518292218)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518292218 NPI number — ST. CLAIR COUNTY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ST. CLAIR COUNTY
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1518292218
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/14/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
33205 US HIGHWAY 231
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ASHVILLE
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35953-6040
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
205-594-7131
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
33205 US HIGHWAY 231
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ASHVILLE
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35953-6040
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-594-7131
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/14/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SEALS
Authorized Official First Name:
EDITH
Authorized Official Middle Name:
V
Authorized Official Title or Position:
SUPERINTENDENT
Authorized Official Telephone Number:
205-594-7131

Provider Taxonomy Codes

  • Taxonomy code: 251300000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 064058000 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 065058000 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 089058000 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 052058000 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 022058000 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 068058000 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".