Healthcare Provider Details

I. General information

NPI: 1972658755
Provider Name (Legal Business Name): MANCHESTER BOARD OF HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 W PERRY ST
MANCHESTER GA
31816-1346
US

IV. Provider business mailing address

PO BOX 373
MANCHESTER GA
31816-0373
US

V. Phone/Fax

Practice location:
  • Phone: 706-846-3353
  • Fax:
Mailing address:
  • Phone: 706-846-3353
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License NumberREF000026462
License Number StateGA

VIII. Authorized Official

Name: KYLIE MYHAND
Title or Position: BILLING SUPERVISOR
Credential:
Phone: 706-298-7709