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General NPI Number Information
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NPI Number | 1962569798
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Entity Type | Organization
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Legal Business Name | SOUTH HEALTH DISTRICT
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Dates
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Enumeration Date | 01/02/2007
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Last Update Date | 05/20/2025
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Provider Practice Location Address
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Address Line | 1205 TIFT AVE N
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City | TIFTON
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State | GA
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Zip | 31794-4033
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Country | US
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Telephone | 229-391-9281
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5147
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City | VALDOSTA
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State | GA
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Zip | 31603-5147
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Country | US
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Telephone | 229-333-5290
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Fax | 229-333-7822
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Authorized Official
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Title or Position | DISTRICT ADMINISTRATOR
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Name | MRS. ALLIE PRIDGEN
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Credential |
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Telephone | 229-333-5290
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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