Healthcare Provider Details

I. General information

NPI: 1770552234
Provider Name (Legal Business Name): COBB COUNTY BOARD OF HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2006
Last Update Date: 07/28/2020
Certification Date: 07/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3810 OLD 41 HWY NW
KENNESAW GA
30144-1059
US

IV. Provider business mailing address

1650 COUNTY SERVICES PKWY SW
MARIETTA GA
30008-4010
US

V. Phone/Fax

Practice location:
  • Phone: 770-974-3330
  • Fax: 770-966-9192
Mailing address:
  • Phone: 770-514-2361
  • Fax: 770-514-2811

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: VALERIE PRINCE
Title or Position: DIRECTOR OF ADMINISTRATION
Credential: DIRECTOR
Phone: 770-514-2354