=====================================================
General NPI Number Information
=====================================================
NPI Number | 1386815140
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | UNION COUNTY HEALTH DEPARTMENT
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/19/2008
-----------------------------------------------------
Last Update Date | 03/19/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 175 CHASE DR.
-----------------------------------------------------
City | BLAIRSVILLE
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30512
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 706-745-6292
-----------------------------------------------------
Fax | 706-745-6803
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 175 CHASE DR.
-----------------------------------------------------
City | BLAIRSVILLE
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30512
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 706-745-6292
-----------------------------------------------------
Fax | 706-745-6803
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO OF UNION CO. BOARD OF HEALTH
-----------------------------------------------------
Name | DR. DAVID N. WESTFALL
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 770-535-5743
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251K00000X
-----------------------------------------------------
Taxonomy Name | Public Health or Welfare Agency
-----------------------------------------------------
License Number | RN195059
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------