MEDICARE: WHEELER COUNTY HEALTH DEPARTMENT

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

General Provider Information

NPI Number	:	1376611947
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WHEELER COUNTY HEALTH DEPARTMENT

Provider Business Mailing Address
First Line	:	PO BOX 669
Second Line	:
City	:	ALAMO
State	:	GA
Zip	:	30411-0669
Country	:	US
Telephone Number	:	912-568-7161
Fax Number	:	912-568-7770

Provider Business Practice Location Address
First Line	:	414 KENT STREET
Second Line	:
City	:	ALAMO
State	:	GA
Zip	:	30411
Country	:	US
Telephone Number	:	912-568-7161
Fax Number	:	912-568-7770

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	CANDACE SPICER CHRISTIAN
Credential	:
Telephone Number	:	478-275-6545

Provider Enumeration Date	:	12/01/2006
Last Update Date	:	11/10/2011

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