Provider Demographics
NPI:1073033551
Name:CLARKE COUNTY HEALTH DEPT STD
Entity Type:Organization
Organization Name:CLARKE 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 1:22600 HIGHWAY 84
Practice Address - Street 2:
Practice Address - City:GROVE HILL
Practice Address - State:AL
Practice Address - Zip Code:36451-5481
Practice Address - Country:US
Practice Address - Phone:251-275-3772
Practice Address - Fax:251-275-8066
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALABAMA DEPARTMENT OF PUBLIC HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-06-26
Last Update Date:2017-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare