Provider Demographics
NPI:1548245350
Name:SPALDING COUNTY BOARD OF HEALTH
Entity Type:Organization
Organization Name:SPALDING COUNTY BOARD OF HEALTH
Other - Org Name:SPALDING COUNTY HEALTH DEPARTMENT
Other - Org Type:Other Name
Authorized Official - Title/Position:BILLING SUPERVISOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:ELLINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-298-7732
Mailing Address - Street 1:PO BOX 129
Mailing Address - Street 2:
Mailing Address - City:GRIFFIN
Mailing Address - State:GA
Mailing Address - Zip Code:30224-0004
Mailing Address - Country:US
Mailing Address - Phone:770-467-4740
Mailing Address - Fax:770-229-3169
Practice Address - Street 1:1007 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:GRIFFIN
Practice Address - State:GA
Practice Address - Zip Code:30223-4445
Practice Address - Country:US
Practice Address - Phone:770-467-4740
Practice Address - Fax:770-229-3169
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-14
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000052093KMedicaid
GA000461744CMedicaid
GA000453263PMedicaid
GA000456453MMedicaid
GA000784385AMedicaid