Provider Demographics
NPI:1356332167
Name:CAMDEN COUNTY HEALTH DEPARTMENT
Entity Type:Organization
Organization Name:CAMDEN COUNTY HEALTH DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:W
Authorized Official - Last Name:DUFFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-576-3040
Mailing Address - Street 1:600 CHARLES GILMAN JR AVE
Mailing Address - Street 2:
Mailing Address - City:KINGSLAND
Mailing Address - State:GA
Mailing Address - Zip Code:31548-6290
Mailing Address - Country:US
Mailing Address - Phone:912-729-4554
Mailing Address - Fax:912-729-6056
Practice Address - Street 1:600 CHARLES GILMAN JR AVE
Practice Address - Street 2:
Practice Address - City:KINGSLAND
Practice Address - State:GA
Practice Address - Zip Code:31548-6290
Practice Address - Country:US
Practice Address - Phone:912-729-4554
Practice Address - Fax:912-729-6056
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CAMDEN COUNTY HEALTH DEPARTMENT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-11-01
Last Update Date:2010-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000453219KMedicaid
GA000456508CMedicaid
GA000051818CMedicaid
GA10057388Medicaid
GA000457938CMedicaid
GA336058Medicaid
GA000551911AMedicaid
GA100778Medicare ID - Type UnspecifiedAVES
GA000453219KMedicaid
GA000551911AMedicaid