Healthcare Provider Details

I. General information

NPI: 1295899201
Provider Name (Legal Business Name): SOUTH HEALTH DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2006
Last Update Date: 05/20/2025
Certification Date: 05/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

745 HUDSON AVE
ASHBURN GA
31714-5312
US

IV. Provider business mailing address

PO BOX 5147
VALDOSTA GA
31603-5147
US

V. Phone/Fax

Practice location:
  • Phone: 229-567-4357
  • Fax: 229-567-3947
Mailing address:
  • Phone: 229-333-5290
  • Fax: 229-333-7822

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. ALLIE PRIDGEN
Title or Position: DISTRICT ADMINISTRATOR
Credential:
Phone: 229-333-5290