MEDICARE: CHATHAM 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
1	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1700276441
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHATHAM 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	:	410 MALL BLVD STE G
Second Line	:
City	:	SAVANNAH
State	:	GA
Zip	:	31406-4869
Country	:	US
Telephone Number	:	912-692-4575
Fax Number	:	912-692-4576

Authorized Official
Title or Position	:	DISTRICT BILLING DEPT COORDINATOR
Name	:	STACY COOPER
Credential	:
Telephone Number	:	912-262-2347

Provider Enumeration Date	:	02/03/2015
Last Update Date	:	02/03/2015

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Directions to “CHATHAM COUNTY BOARD OF HEALTH ” Practice Location

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