Provider Demographics
NPI: | 1225559453 |
---|---|
Name: | WALKER COUNTY HEALTH DEPT STD |
Entity type: | Organization |
Organization Name: | WALKER COUNTY HEALTH DEPT STD |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | CBU DIRECTOR |
Authorized Official - Prefix: | MS |
Authorized Official - First Name: | ARNITA |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | SHEPHERD |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MSW |
Authorized Official - Phone: | 334-206-7065 |
Mailing Address - Street 1: | 201 MONROE STREET SUITE 1600 |
Mailing Address - Street 2: | RSA TOWER - CENTRALIZED BILLING UNIT |
Mailing Address - City: | MONTGOMERY |
Mailing Address - State: | AL |
Mailing Address - Zip Code: | 36104-3721 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 334-206-7065 |
Mailing Address - Fax: | 334-206-3998 |
Practice Address - Street 1: | 705 20TH AVE E |
Practice Address - Street 2: | |
Practice Address - City: | JASPER |
Practice Address - State: | AL |
Practice Address - Zip Code: | 35501-4071 |
Practice Address - Country: | US |
Practice Address - Phone: | 205-221-9778 |
Practice Address - Fax: | 205-221-8810 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | Yes |
Parent Organization LBN: | ALABAMA DEPARTMENT OF PUBLIC HEALTH |
Parent Organization TIN: | <UNAVAIL> |
Enumeration Date: | 2017-06-28 |
Last Update Date: | 2024-09-16 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 251K00000X | Agencies | Public Health or Welfare |