Provider Demographics
NPI:1346303963
Name:CHEROKEE COUNTY HEALTH DEPT
Entity Type:Organization
Organization Name:CHEROKEE COUNTY HEALTH DEPT
Other - Org Name:CHEROKEE COUNTY BOARD OF HEALTH
Other - Org Type:Other Name
Authorized Official - Title/Position:BILLING SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:KELLI
Authorized Official - Middle Name:
Authorized Official - Last Name:KINSEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-529-5757
Mailing Address - Street 1:1710 WHITEHOUSE CT
Mailing Address - Street 2:
Mailing Address - City:DALTON
Mailing Address - State:GA
Mailing Address - Zip Code:30720-8523
Mailing Address - Country:US
Mailing Address - Phone:706-529-5757
Mailing Address - Fax:706-529-5740
Practice Address - Street 1:1710 WHITEHOUSE CT
Practice Address - Street 2:
Practice Address - City:DALTON
Practice Address - State:GA
Practice Address - Zip Code:30720-8523
Practice Address - Country:US
Practice Address - Phone:095-295-7577
Practice Address - Fax:706-529-5740
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHEROKEE COUNTY HEALTH DEPARTMENT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-12-18
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA119796094BMedicaid
GA=========OtherTAX ID