Healthcare Provider Details

I. General information

NPI: 1558390757
Provider Name (Legal Business Name): TOOMBS COUNTY BOARD OF HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2006
Last Update Date: 02/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

714 NW BROAD ST
LYONS GA
30436-5648
US

IV. Provider business mailing address

PO BOX 308
LYONS GA
30436-0308
US

V. Phone/Fax

Practice location:
  • Phone: 912-526-8108
  • Fax: 912-526-6504
Mailing address:
  • Phone: 912-526-8108
  • Fax: 912-526-6504

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