Provider Demographics
NPI:1326075383
Name:SUMTER COUNTY BOARD OF HEALTH
Entity Type:Organization
Organization Name:SUMTER COUNTY BOARD OF HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTH DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ZSOLT
Authorized Official - Middle Name:
Authorized Official - Last Name:KOPPANYI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:706-321-6300
Mailing Address - Street 1:208 RUCKER STREET
Mailing Address - Street 2:
Mailing Address - City:AMERICUS
Mailing Address - State:GA
Mailing Address - Zip Code:31719
Mailing Address - Country:US
Mailing Address - Phone:229-924-3637
Mailing Address - Fax:229-928-9863
Practice Address - Street 1:208 RUCKER STREET
Practice Address - Street 2:
Practice Address - City:AMERICUS
Practice Address - State:GA
Practice Address - Zip Code:31719
Practice Address - Country:US
Practice Address - Phone:229-924-3637
Practice Address - Fax:229-928-9863
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-27
Last Update Date:2010-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00677377AMedicaid
GA00052082NMedicaid
GA00457729HMedicaid
GA00453164BMedicaid
GA00058726PMedicaid
GAFLU099Medicare PIN