Provider Demographics
NPI:1235185935
Name:HABERSHAM COUNTY HEALTH DEPARTMENT
Entity Type:Organization
Organization Name:HABERSHAM COUNTY HEALTH DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTH DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:N
Authorized Official - Last Name:WESTFALL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-535-5743
Mailing Address - Street 1:185 SCOGGINS DR
Mailing Address - Street 2:
Mailing Address - City:DEMOREST
Mailing Address - State:GA
Mailing Address - Zip Code:30535-5355
Mailing Address - Country:US
Mailing Address - Phone:706-778-7156
Mailing Address - Fax:706-776-7694
Practice Address - Street 1:185 SCOGGINS DR
Practice Address - Street 2:
Practice Address - City:DEMOREST
Practice Address - State:GA
Practice Address - Zip Code:30535-5355
Practice Address - Country:US
Practice Address - Phone:706-778-7156
Practice Address - Fax:706-776-7694
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-25
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000649437AMedicaid
GA000051972FMedicaid
GA000442945FMedicaid
GA000595977BMedicaid
GA000456442JMedicaid
GAFLU177Medicare ID - Type UnspecifiedINFLUENZA AND PNEUMONIA