Provider Demographics
NPI:1114603933
Name:STATE OF ALABAMA DEPARTMENT OF PUBLIC HEALTH - WELLNESS
Entity Type:Organization
Organization Name:STATE OF ALABAMA DEPARTMENT OF PUBLIC HEALTH - WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR WELLNESS PROGRAM
Authorized Official - Prefix:MS
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:MYSINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-206-5571
Mailing Address - Street 1:201 MONROE ST STE 986
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36104-6960
Mailing Address - Country:US
Mailing Address - Phone:334-206-5571
Mailing Address - Fax:
Practice Address - Street 1:201 MONROE ST STE 986
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36104-6960
Practice Address - Country:US
Practice Address - Phone:334-206-5571
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-26
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare