MEDICARE: MANCHESTER BOARD OF HEALTH

Medicare Provider Information

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	REF000026462	GA

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

NPI Number	:	1972658755
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MANCHESTER BOARD OF HEALTH

Provider Business Mailing Address
First Line	:	PO BOX 373
Second Line	:
City	:	MANCHESTER
State	:	GA
Zip	:	31816-0373
Country	:	US
Telephone Number	:	706-846-3353
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 W PERRY ST
Second Line	:
City	:	MANCHESTER
State	:	GA
Zip	:	31816-1346
Country	:	US
Telephone Number	:	706-846-3353
Fax Number	:

Authorized Official
Title or Position	:	BILLING SUPERVISOR
Name	:	KYLIE MYHAND
Credential	:
Telephone Number	:	706-298-7709

Provider Enumeration Date	:	01/24/2007
Last Update Date	:	12/01/2025

300 W PERRY ST
MANCHESTER, GA
31816-1346

Practice Phone: 706-846-3353
Practice Fax: 706-846-2674