| Organization Name: | ELMORE COUNTY HEALTH DEPT OFFSITE EPSDT |
| NPI Number: | 1164565495 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | REGINA L PATTERSON (DIRECTOR OF HEALTH SYSTEMS) |
| Mailing Address: | 6501 Us Highway 231 Wetumpka |
| State: | AL US |
| Postal Code: | 360922837 |
| Phone Number: | 3345671171 |
| Fax Number: | |
| NPI Enumeration Date: | 02/15/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251K00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Public Health or Welfare |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |