MEDICARE: DEKALB COUNTY BOARD OF HEALTH

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number State
1	261QA0006X	Ambulatory Fertility Facility	GA
2	251K00000X	Public Health or Welfare Agency	GA
3	251X00000X	Supports Brokerage Agency	GA
4	261QF0400X	Federally Qualified Health Center (FQHC)	GA
5	251K00000X	Public Health or Welfare Agency

General Provider Information

NPI Number	:	1356447411
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DEKALB COUNTY BOARD OF HEALTH

Provider Business Mailing Address
First Line	:	445 WINN WAY
Second Line	:	PO BOX 987
City	:	DECATUR
State	:	GA
Zip	:	30030-1707
Country	:	US
Telephone Number	:	404-294-3701
Fax Number	:	404-508-7862

Provider Business Practice Location Address
First Line	:	3110 CLIFTON SPRINGS RD
Second Line	:
City	:	DECATUR
State	:	GA
Zip	:	30034-4600
Country	:	US
Telephone Number	:	404-244-2200
Fax Number	:	404-638-0344

Authorized Official
Title or Position	:	DISTRICT DIRECTOR/CEO
Name	:	SANDRA E FORD
Credential	:	MD
Telephone Number	:	404-294-3787

Provider Enumeration Date	:	09/16/2006
Last Update Date	:	10/23/2007

Similar Medicare Providers

1891743753 — LIZY THALIATH MD
Practice Location Address:

3110 CLIFTON SPRINGS RD
DECATUR, GA
30034-4600

Practice Phone: 404-243-9500
Practice Fax:

1770535791 — ROBERT LEE UTLEY DDS
Practice Location Address:

3110 CLIFTON SPRINGS RD
DECATUR, GA
30034-4600

Practice Phone: 404-244-2200
Practice Fax: 404-638-0344

1679657597 — MARILYN CROWDER O'BRIEN RN
Practice Location Address:

3110 CLIFTON SPRINGS RD
DECATUR, GA
30034-4600

Practice Phone: 404-244-2218
Practice Fax: 404-638-0344

1679657498 — ALECIA REBECCA KATES RN
Practice Location Address:

3110 CLIFTON SPRINGS RD , SUITE D
DECATUR, GA
30034-4600

Practice Phone: 404-244-2200
Practice Fax: 404-638-0309

1528142262 — CAROLYN GAINES HENDRICKS NP
Practice Location Address:

3110 CLIFTON SPRINGS RD , SUITE D
DECATUR, GA
30034-4600

Practice Phone: 404-244-2200
Practice Fax: 404-638-0309

1922183300 — VELMA BENTON-HAMLER RN
Practice Location Address:

3110 CLIFTON SPRINGS RD
DECATUR, GA
30034-4600

Practice Phone: 404-244-2200
Practice Fax: 404-638-0309

Directions to “DEKALB COUNTY BOARD OF HEALTH ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.