MOBILE COUNTY BOARD OF HEALTH NPI 1053406280

NPI Information

NPI: 1053406280
Provider Name: MOBILE COUNTY BOARD OF HEALTH

Doing Business As: CITRONELLE CLINIC

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
19250 N MOBILE ST
CITRONELLE, AL
ZIP 36522
Phone: (251) 866-9129
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MOBILE COUNTY BOARD OF HEALTH is a federally qualified health center (fqhc) clinic center in Citronelle, AL. MOBILE COUNTY BOARD OF HEALTH NPI is 1053406280. The provider is registered as an organization entity type.
The provider Is Doing Business As Citronelle Clinic.

The provider's business location address is:

19250 N MOBILE ST
CITRONELLE, AL
ZIP 36522-122
Phone: (251) 866-9129
Fax: (251) 866-9121

The provider's authorized official is Kelly Warren .
The authorized official title is Executive Director and has the following contact phone number (251) 690-8158.

The enumeration date for this NPI number is 10/4/2006 and was last updated on 4/29/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	630001013	MEDICAID	ALABAMA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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