Healthcare Provider Details

I. General information

NPI: 1932416674
Provider Name (Legal Business Name): EMANUEL COUNTY BOARD OF HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2010
Last Update Date: 03/20/2020
Certification Date: 03/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

503 S RAILROAD AVE
TWIN CITY GA
30471
US

IV. Provider business mailing address

50 HIGHWAY 56 N
SWAINSBORO GA
30401-4441
US

V. Phone/Fax

Practice location:
  • Phone: 478-763-3452
  • Fax:
Mailing address:
  • Phone: 478-237-7501
  • Fax: 478-289-2501

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: SHANNON C NEWTON
Title or Position: DISTRICT BILLING SUPERVISOR
Credential:
Phone: 706-667-4265