Provider Demographics
NPI:1306838586
Name:TROUP COUNTY BOARD OF HEALTH
Entity Type:Organization
Organization Name:TROUP COUNTY BOARD OF HEALTH
Other - Org Name:TROUP COUNTY HEALTH DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:ELLINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-298-7732
Mailing Address - Street 1:900 DALLIS ST
Mailing Address - Street 2:
Mailing Address - City:LAGRANGE
Mailing Address - State:GA
Mailing Address - Zip Code:30240-4401
Mailing Address - Country:US
Mailing Address - Phone:706-845-4085
Mailing Address - Fax:706-845-4089
Practice Address - Street 1:900 DALLIS ST
Practice Address - Street 2:
Practice Address - City:LAGRANGE
Practice Address - State:GA
Practice Address - Zip Code:30240-4401
Practice Address - Country:US
Practice Address - Phone:706-845-4085
Practice Address - Fax:706-845-4089
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-16
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local
Provider Identifiers
StateIdentifier IDID TypeIssuer
00456453POtherDSPS
00654508AOtherPERINATAL
000058737AOtherFAMILY PLANNING
00052093LOtherEPSDT
00052093LOtherEPSDT
00456453POtherDSPS