Healthcare Provider Details

I. General information

NPI: 1255339529
Provider Name (Legal Business Name): GLYNN COUNTY HEATLH DEPARTMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 SCRANTON CONNECTOR
BRUNSWICK GA
31525-0540
US

IV. Provider business mailing address

150 SCRANTON CONNECTOR
BRUNSWICK GA
31525-0540
US

V. Phone/Fax

Practice location:
  • Phone: 912-262-3045
  • Fax: 912-262-3051
Mailing address:
  • Phone: 912-262-2300
  • Fax: 912-262-2315

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: MR. BRENT JORDAN
Title or Position: DISTRICT ADMINISTRATOR
Credential:
Phone: 912-262-3045