Provider Demographics
NPI:1639393812
Name:HALL COUNTY BOARD OF HEALTH
Entity Type:Organization
Organization Name:HALL COUNTY BOARD OF HEALTH
Other - Org Name:DHR PUBLIC HEALTH
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO/HALL CO BOARD OF HEALTH
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:NOEL
Authorized Official - Last Name:WESTFALL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-535-5743
Mailing Address - Street 1:1280 ATHENS ST
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30507
Mailing Address - Country:US
Mailing Address - Phone:770-535-5867
Mailing Address - Fax:770-535-5958
Practice Address - Street 1:1280 ATHENS ST
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30507-7000
Practice Address - Country:US
Practice Address - Phone:770-535-5885
Practice Address - Fax:770-535-5749
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPN057120GA164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA253676690Medicaid