Healthcare Provider Details

I. General information

NPI: 1659345627
Provider Name (Legal Business Name): GILMER COUNTY BOARD OF HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2006
Last Update Date: 08/26/2022
Certification Date: 08/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28 SOUTHSIDE CHURCH ST
ELLIJAY GA
30540-5409
US

IV. Provider business mailing address

28 SOUTHSIDE CHURCH ST
ELLIJAY GA
30540-5409
US

V. Phone/Fax

Practice location:
  • Phone: 706-635-4363
  • Fax: 706-276-4363
Mailing address:
  • Phone: 706-635-4363
  • Fax: 706-635-4363

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: KELLI KINSEY
Title or Position: BILLING SUPERVISOR
Credential:
Phone: 706-529-5757