Healthcare Provider Details

I. General information

NPI: 1124112339
Provider Name (Legal Business Name): BANKS COUNTY HEALTH DEPARTMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

667 THOMPSON STREET
HOMER GA
30547
US

IV. Provider business mailing address

667 THOMPSON ST
HOMER GA
30547-3110
US

V. Phone/Fax

Practice location:
  • Phone: 706-677-2296
  • Fax: 706-677-4042
Mailing address:
  • Phone: 706-677-2296
  • Fax: 706-677-4042

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number015524
License Number StateGA

VIII. Authorized Official

Name: DAVID N WESTFALL
Title or Position: PUBLIC HEALTH DIRECTOR
Credential: M.D.
Phone: 706-677-2296