1417477258 NPI number — BARBOUR COUNTY HEALTH DEPT (CLAYTON) STD

Table of content: (NPI 1417477258)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417477258 NPI number — BARBOUR COUNTY HEALTH DEPT (CLAYTON) STD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BARBOUR COUNTY HEALTH DEPT (CLAYTON) STD
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:
1417477258
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/18/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
201 MONROE ST STE 1600
Provider Second Line Business Mailing Address:
RSA TOWER - CENTRALIZED BILLING UNIT
Provider Business Mailing Address City Name:
MONTGOMERY
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
36104-3721
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
334-206-7065
Provider Business Mailing Address Fax Number:
334-206-3998

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
39 BROWDER ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CLAYTON
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
36016-2079
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
334-775-9044
Provider Business Practice Location Address Fax Number:
334-775-9129
Provider Enumeration Date:
06/22/2017

Additional Information

Authorized Official

Authorized Official Last Name:
SHEPHERD
Authorized Official First Name:
ARNITA
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR, CBU
Authorized Official Telephone Number:
334-206-7065

Provider Taxonomy Codes

  • Taxonomy code: 251K00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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