MEDICARE: TELFAIR 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	:	1548338692
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TELFAIR COUNTY HEALTH DEPARTMENT

Provider Business Mailing Address
First Line	:	PO BOX 328
Second Line	:	P.O. BOX 328
City	:	MC RAE
State	:	GA
Zip	:	31055-0328
Country	:	US
Telephone Number	:	229-868-7404
Fax Number	:	229-868-7245

Provider Business Practice Location Address
First Line	:	89 TELFAIR AVE
Second Line	:
City	:	MC RAE
State	:	GA
Zip	:	31055-2163
Country	:	US
Telephone Number	:	229-868-7404
Fax Number	:	229-868-7245

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

Provider Enumeration Date	:	11/30/2006
Last Update Date	:	11/10/2011

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Directions to “TELFAIR COUNTY HEALTH DEPARTMENT ” Practice Location

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