Provider Demographics
NPI:1497807366
Name:BOARD OF HEALTH WHITE COUNTY
Entity Type:Organization
Organization Name:BOARD OF HEALTH WHITE COUNTY
Other - Org Name:WHITE COUNTY HEALTH DEPARTMENT
Other - Org Type:Other Name
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:STACY
Authorized Official - Middle Name:T
Authorized Official - Last Name:POLLARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-865-2191
Mailing Address - Street 1:1331 HELEN HWY
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:GA
Mailing Address - Zip Code:30528-2834
Mailing Address - Country:US
Mailing Address - Phone:706-865-2191
Mailing Address - Fax:706-865-7745
Practice Address - Street 1:1331 HELEN HWY
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:GA
Practice Address - Zip Code:30528-2834
Practice Address - Country:US
Practice Address - Phone:706-865-2191
Practice Address - Fax:706-865-7745
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000924679BMedicaid
GA000051972NMedicaid
GA000058638AMedicaid
GA000442945OMedicaid
GA000456442AMedicaid
GA10044067Medicaid
GA342691Medicaid
GA000051972NMedicaid