Provider Demographics
NPI:1568491785
Name:WARE COUNTY BOARD OF HEALTH
Entity Type:Organization
Organization Name:WARE COUNTY BOARD OF HEALTH
Other - Org Name:WARE COUNTY WELLNESS CENTER
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DISTRICT HEALTH DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROSEMARIE
Authorized Official - Middle Name:D
Authorized Official - Last Name:PARKS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:912-285-6002
Mailing Address - Street 1:1101 CHURCH STRETE
Mailing Address - Street 2:
Mailing Address - City:WAYCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:31501
Mailing Address - Country:US
Mailing Address - Phone:912-632-3208
Mailing Address - Fax:912-632-7834
Practice Address - Street 1:1102 PLANT AVENUE
Practice Address - Street 2:
Practice Address - City:WAYCROSS
Practice Address - State:GA
Practice Address - Zip Code:31501
Practice Address - Country:US
Practice Address - Phone:912-285-6002
Practice Address - Fax:912-287-6764
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-01
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA10068154Medicaid
GAFLU135Medicare ID - Type UnspecifiedCOUNTY FLU BILLING #