Provider Demographics
NPI:1871766410
Name:SHELBY COUNTY HEALTH DEPARTMENT
Entity type:Organization
Organization Name:SHELBY COUNTY HEALTH DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AREA 5 ADMINISTRATOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:GOMILLION
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-927-7000
Mailing Address - Street 1:PO BOX 846
Mailing Address - Street 2:2000 COUNTY SERVICES DRIVE
Mailing Address - City:PELHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35124-0846
Mailing Address - Country:US
Mailing Address - Phone:205-664-2470
Mailing Address - Fax:205-664-4148
Practice Address - Street 1:2000 COUNTY SERVICES DR.
Practice Address - Street 2:
Practice Address - City:PELHAM
Practice Address - State:AL
Practice Address - Zip Code:35124
Practice Address - Country:US
Practice Address - Phone:205-664-2470
Practice Address - Fax:205-664-4148
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-03
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare