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Coffee County Health Dept-Elba Mat

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

NPI 1356490197 · NPPES record last updated Sep 18, 2024

Key facts

NPI
1356490197
Entity type
Organization (NPI type 2)
Primary specialty
Public Health or Welfare Agency 251K00000X
Legal business name
COFFEE COUNTY HEALTH DEPT-ELBA MAT
Practice address
North Court Avenue
Elba, AL 36323-0000
Phone
(334) 347-9574
NPI assigned
Jan 10, 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
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
391610000MedicaidAL

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 18, 2024.

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726617600000",
    "number": "1356490197",
    "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 MAT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-10",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "391610000",
            "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.