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NPI Code Detail

MEDICARE: LIBERTY COUNTY BOARD OF HEALTH

MEDICARE: LIBERTY 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 License Number State
1251K00000XPublic Health or Welfare Agency

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3FLU146OTHERGAMEDICARE ID

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1407839061
Entity Type Code : Organization
Provider Name (Legal Business Name) : LIBERTY COUNTY BOARD OF HEALTH
Provider Business Mailing Address
First Line : 150 SCRANTON CONNECTOR
Second Line :
City : BRUNSWICK
State : GA
Zip : 31525-0540
Country : US
Telephone Number : 912-262-2347
Fax Number : 912-262-3036
Provider Business Practice Location Address
First Line : 1113 E OGLETHORPE HWY
Second Line :
City : HINESVILLE
State : GA
Zip : 31313-1200
Country : US
Telephone Number : 912-876-2173
Fax Number : 912-368-8033
Authorized Official
Title or Position : DISTRICT BILLING DEPT. COORDINATOR
Name : STACY A. COOPER
Credential :
Telephone Number : 912-262-2347
Provider Enumeration Date : 11/28/2005
Last Update Date : 01/06/2015

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Directions to “LIBERTY COUNTY BOARD OF HEALTH ” Practice Location

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