Provider Demographics
NPI:1851632046
Name:FORSYTH COUNTY HEALTH DEPARTMENT
Entity Type:Organization
Organization Name:FORSYTH COUNTY HEALTH DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PUBLIC HEALTH NURSE
Authorized Official - Prefix:
Authorized Official - First Name:JANELL
Authorized Official - Middle Name:M
Authorized Official - Last Name:BALL
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:770-781-6900
Mailing Address - Street 1:428 CANTON RD
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040-2002
Mailing Address - Country:US
Mailing Address - Phone:770-781-6900
Mailing Address - Fax:770-781-6929
Practice Address - Street 1:428 CANTON RD
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-2002
Practice Address - Country:US
Practice Address - Phone:770-781-6900
Practice Address - Fax:770-781-6929
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-13
Last Update Date:2013-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN215679251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care