Provider Demographics
NPI:1467895045
Name:FULTON COUNTY DEPARTMENT OF HEALTH
Entity Type:Organization
Organization Name:FULTON COUNTY DEPARTMENT OF HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PUBLIC HELATH NURSE III
Authorized Official - Prefix:MS
Authorized Official - First Name:TISA
Authorized Official - Middle Name:W
Authorized Official - Last Name:DUPREE BRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:404-613-8618
Mailing Address - Street 1:99 JESSE HILL JR DR SE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30303-3030
Mailing Address - Country:US
Mailing Address - Phone:404-613-8618
Mailing Address - Fax:404-730-1499
Practice Address - Street 1:99 JESSE HILL JR DR SE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30303-3030
Practice Address - Country:US
Practice Address - Phone:404-613-8618
Practice Address - Fax:404-730-1499
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-12
Last Update Date:2013-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAR080890261QP0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local