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Coffee County Health Dept-Elba Child

Organization Active NPI Public Health or Welfare Agency · Elba, AL

NPI 1083757405 · NPPES record last updated Sep 13, 2024

Key facts

NPI
1083757405
Entity type
Organization (NPI type 2)
Primary specialty
Public Health or Welfare Agency 251K00000X
Legal business name
COFFEE COUNTY HEALTH DEPT-ELBA CHILD
Practice address
North Court Avenue
Elba, AL 36323-0000
Phone
(334) 347-9574
NPI assigned
Feb 15, 2007
Organization subpart
No

Authorized official

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

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
St Clair County Health Dept-Ashville AIDS (1,340 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X
Public Health or Welfare Agency 251K00000X Yes

Addresses

Primary practice location

North Court Avenue
Elba, AL 36323-0000

Mailing address

North Court Avenue
Elba, AL 36323-0000

Other identifiers

IdentifierTypeStateIssuer
590100021MedicaidAL

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 13, 2024.

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726185600000",
    "number": "1083757405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "NORTH COURT AVENUE",
            "city": "ELBA",
            "state": "AL",
            "postal_code": "363230000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NORTH COURT AVENUE",
            "city": "ELBA",
            "state": "AL",
            "postal_code": "363230000",
            "telephone_number": "334-347-9574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COFFEE COUNTY HEALTH DEPT-ELBA CHILD",
        "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": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "590100021",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elba, AL

All providers in Elba, AL · Public Health or Welfare Agency in Alabama

Sources for this page

Verify at the official NPI Registry.