Provider Demographics
NPI:1578630695
Name:SOUTH HEALTH DISTRICT
Entity Type:Organization
Organization Name:SOUTH HEALTH DISTRICT
Other - Org Name:COOK COUNTY BOARD OF HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DISTRICT ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SHERRIE
Authorized Official - Middle Name:B
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-245-6439
Mailing Address - Street 1:PO BOX 5147
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31603-5147
Mailing Address - Country:US
Mailing Address - Phone:229-333-5290
Mailing Address - Fax:229-333-7822
Practice Address - Street 1:204 N PARRISH AVE
Practice Address - Street 2:
Practice Address - City:ADEL
Practice Address - State:GA
Practice Address - Zip Code:31620-2327
Practice Address - Country:US
Practice Address - Phone:229-896-3030
Practice Address - Fax:229-896-4751
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA342608OtherWELLCARE
GAFLU207Medicare ID - Type UnspecifiedCOOK FLU