MEDICARE: SOUTH HEALTH DISTRICT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251K00000X	Public Health or Welfare Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	340818	OTHER	GA	WELLCARE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1154498251
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTH HEALTH DISTRICT

Provider Business Mailing Address
First Line	:	PO BOX 5147
Second Line	:
City	:	VALDOSTA
State	:	GA
Zip	:	31603-5147
Country	:	US
Telephone Number	:	229-333-5290
Fax Number	:	229-333-7822

Provider Business Practice Location Address
First Line	:	600A S JEFFERSON ST
Second Line	:
City	:	NASHVILLE
State	:	GA
Zip	:	31639-2514
Country	:	US
Telephone Number	:	229-686-5411
Fax Number	:	229-686-9015

Authorized Official
Title or Position	:	DISTRICT ADMINISTRATOR
Name	:	MRS. ALLIE PRIDGEN
Credential	:
Telephone Number	:	229-333-5290

Provider Enumeration Date	:	11/30/2006
Last Update Date	:	05/20/2025

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Directions to “SOUTH HEALTH DISTRICT ” Practice Location

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