Provider Demographics
NPI:1154498251
Name:SOUTH HEALTH DISTRICT
Entity Type:Organization
Organization Name:SOUTH HEALTH DISTRICT
Other - Org Name:BERRIEN COUNTY BOARD OF HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DISTRICT ACCOUNTANT
Authorized Official - Prefix:MS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:PARRISH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-249-2794
Mailing Address - Street 1:PO BOX 5147
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31603-5147
Mailing Address - Country:US
Mailing Address - Phone:229-333-5290
Mailing Address - Fax:229-333-7822
Practice Address - Street 1:600A S JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:GA
Practice Address - Zip Code:31639-2514
Practice Address - Country:US
Practice Address - Phone:229-686-5411
Practice Address - Fax:229-686-9015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-30
Last Update Date:2019-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000457762EMedicaid
GA000052038CMedicaid
GA000452559AMedicaid
GA340818OtherWELLCARE