Healthcare Provider Details

I. General information

NPI: 1194273896
Provider Name (Legal Business Name): FULTON COUNTY HEALTH DEPARTMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2016
Last Update Date: 09/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 JESSE HILL JR DR SE SUITE 402
ATLANTA GA
30303-3030
US

IV. Provider business mailing address

2805 METROPOLITAN PKWY SW
ATLANTA GA
30315-7915
US

V. Phone/Fax

Practice location:
  • Phone: 404-613-1257
  • Fax: 404-612-1777
Mailing address:
  • Phone: 404-612-0626
  • Fax: 404-762-4109

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: MELBA MCNEIL
Title or Position: ACCOUNTING SUPERVISOR
Credential:
Phone: 404-613-1257