Healthcare Provider Details

I. General information

NPI: 1609955913
Provider Name (Legal Business Name): WORTH COUNTY BOARD OF EDUCATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

504 E PRICE ST
SYLVESTER GA
31791-1832
US

IV. Provider business mailing address

504 E PRICE ST
SYLVESTER GA
31791-1832
US

V. Phone/Fax

Practice location:
  • Phone: 229-776-8600
  • Fax: 229-776-3729
Mailing address:
  • Phone: 229-776-8600
  • Fax: 229-776-3729

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: DR. GARY RUSSELL
Title or Position: SUPERINTENDENT OF SCHOOLS
Credential:
Phone: 229-776-8600