Healthcare Provider Details

I. General information

NPI: 1457440364
Provider Name (Legal Business Name): PIKE COUNTY BOARD OF HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

541 GRIFFIN STREET
ZEBULON GA
30295
US

IV. Provider business mailing address

PO BOX 342 541 GRIFFIN STREET
ZEBULON GA
30295-0342
US

V. Phone/Fax

Practice location:
  • Phone: 770-567-8972
  • Fax: 770-567-3531
Mailing address:
  • Phone: 770-567-8972
  • Fax: 770-567-3531

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QP0905X
TaxonomyState or Local Public Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

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