MEDICARE: SPALDING COUNTY BOARD OF HEALTH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251K00000X	Public Health or Welfare Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548245350
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPALDING COUNTY BOARD OF HEALTH

Provider Business Mailing Address
First Line	:	PO BOX 129
Second Line	:
City	:	GRIFFIN
State	:	GA
Zip	:	30224-0004
Country	:	US
Telephone Number	:	770-467-4740
Fax Number	:	770-229-3169

Provider Business Practice Location Address
First Line	:	1007 MEMORIAL DR
Second Line	:
City	:	GRIFFIN
State	:	GA
Zip	:	30223-4445
Country	:	US
Telephone Number	:	770-467-4740
Fax Number	:	770-229-3169

Authorized Official
Title or Position	:	BILLING SUPERVISOR
Name	:	KYLIE MYHAND
Credential	:
Telephone Number	:	706-298-7709

Provider Enumeration Date	:	12/14/2005
Last Update Date	:	12/01/2025

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Directions to “SPALDING COUNTY BOARD OF HEALTH ” Practice Location

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