Healthcare Provider Details

I. General information

NPI: 1487878575
Provider Name (Legal Business Name): COBB COUNTY BOARD OF HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2007
Last Update Date: 09/10/2024
Certification Date: 09/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1650 COUNTY SERVICES PKWY SW
MARIETTA GA
30008-4010
US

IV. Provider business mailing address

1650 COUNTY SERVICES PKWY SW
MARIETTA GA
30008-4010
US

V. Phone/Fax

Practice location:
  • Phone: 770-514-2350
  • Fax: 770-514-2393
Mailing address:
  • Phone: 770-514-2350
  • Fax: 770-514-2393

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License Number5653
License Number StateGA
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DR. ADAM E. ALLGOOD
Title or Position: PHARMACIST-IN-CHARGE (PIC)
Credential: PHARM.D., R.PH.
Phone: 770-514-2345