Provider Demographics
NPI:1669631198
Name:ALABAMA DEPT OF PUBLIC HEALTH
Entity Type:Organization
Organization Name:ALABAMA DEPT OF PUBLIC HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACTING DIRECTOR OF FINANCIAL OPERAT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:WHEAT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-206-5364
Mailing Address - Street 1:2090 COLUMBIANA RD
Mailing Address - Street 2:SUITE 1200
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35216
Mailing Address - Country:US
Mailing Address - Phone:205-552-1702
Mailing Address - Fax:800-292-0938
Practice Address - Street 1:2090 COLUMBIANA ROAD
Practice Address - Street 2:SUITE 1200
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35216
Practice Address - Country:US
Practice Address - Phone:205-552-1702
Practice Address - Fax:800-292-0938
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-09
Last Update Date:2014-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL025533336M0002X
AL1107813336M0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336M0002XSuppliersPharmacyMail Order Pharmacy