Healthcare Provider Details

I. General information

NPI: 1508894171
Provider Name (Legal Business Name): CHARLTON COUNTY BOARD OF HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2006
Last Update Date: 06/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2587 THIRD ST
FOLKSTON GA
31537-8964
US

IV. Provider business mailing address

PO BOX 605
FOLKSTON GA
31537-0605
US

V. Phone/Fax

Practice location:
  • Phone: 912-796-2561
  • Fax: 912-496-2623
Mailing address:
  • Phone: 912-496-2561
  • Fax: 912-496-2623

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: STARLA SUTTON
Title or Position: PSO
Credential:
Phone: 912-427-2042