Provider Demographics
NPI:1942460456
Name:ALABAMA DEPARTMENT OF PUBLIC HEALTH
Entity Type:Organization
Organization Name:ALABAMA DEPARTMENT OF PUBLIC HEALTH
Other - Org Name:ALABAMA PUBLIC HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIR HEALTH SERVICES CSC
Authorized Official - Prefix:MRS
Authorized Official - First Name:REGINA
Authorized Official - Middle Name:
Authorized Official - Last Name:PATTERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-206-5061
Mailing Address - Street 1:201 MONROE ST
Mailing Address - Street 2:SUITE 800
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36104-3735
Mailing Address - Country:US
Mailing Address - Phone:334-206-5061
Mailing Address - Fax:
Practice Address - Street 1:201 MONROE ST
Practice Address - Street 2:SUITE 800
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36104-3735
Practice Address - Country:US
Practice Address - Phone:334-206-5061
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-10
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251K00000X
AL01D0641691291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
No291U00000XLaboratoriesClinical Medical Laboratory