NPIMap

Organization Active NPI

Greene County Health Dept Adult Immun

  • Public Health or Welfare Agency
  • Eutaw, AL
National Provider Identifier
1063555472
Registry record updated Sep 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
GREENE COUNTY HEALTH DEPT ADULT IMMUN
Practice address
412 Morrow Avenue
Eutaw, AL 35462-1109
Phone
(205) 372-9361
NPI assigned
Feb 15, 2007
Last updated
Sep 13, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Regina L Patterson
Title
Director of Health Systems
Phone
(334) 206-5061

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X NU Primary

Addresses

Primary practice location

412 Morrow Avenue
Eutaw, AL 35462-1109

Mailing address

PO Box 269
Eutaw, AL 35462-0269

Other identifiers 1

IdentifierTypeStateIssuer
703207777MedicaidAL

National Provider Directory

National Provider Directory
Tax ID family
Escambia County Health Dept-Brewton Mat1,340 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726185600000",
    "number": "1063555472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 269",
            "city": "EUTAW",
            "state": "AL",
            "postal_code": "354620269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 MORROW AVENUE",
            "city": "EUTAW",
            "state": "AL",
            "postal_code": "354621109",
            "telephone_number": "205-372-9361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENE COUNTY HEALTH DEPT ADULT IMMUN",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-15",
        "last_updated": "2024-09-13",
        "certification_date": "2024-09-13",
        "status": "A",
        "authorized_official_last_name": "PATTERSON",
        "authorized_official_first_name": "REGINA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DIRECTOR OF HEALTH SYSTEMS",
        "authorized_official_telephone_number": "334-206-5061"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "703207777",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eutaw, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.