Healthcare Provider Details

I. General information

NPI: 1427093285
Provider Name (Legal Business Name): CRISP COUNTY BOARD OF HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2006
Last Update Date: 09/29/2025
Certification Date: 09/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 E 24TH AVE
CORDELE GA
31015-3834
US

IV. Provider business mailing address

111 E 24TH AVE
CORDELE GA
31015-3834
US

V. Phone/Fax

Practice location:
  • Phone: 833-337-1749
  • Fax: 706-321-6126
Mailing address:
  • Phone: 833-337-1749
  • Fax: 706-321-6126

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: BEVERLEY TOWNSEND
Title or Position: HEALTH DIRECTOR
Credential: M.D.
Phone: 706-321-6108