Provider Demographics
NPI:1881862944
Name:MERWIETHER CO HEALTH DEPARTMENT
Entity Type:Organization
Organization Name:MERWIETHER CO HEALTH DEPARTMENT
Other - Org Name:MERIWETHER SCHOOL/GEW
Other - Org Type:Other Name
Authorized Official - Title/Position:BILLING SUPERVISOR
Authorized Official - Prefix:
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 1:51 GAY CONNECTOR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30222-3339
Mailing Address - Country:US
Mailing Address - Phone:706-672-4974
Mailing Address - Fax:706-672-1065
Practice Address - Street 1:18425 MAIN ST
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:GA
Practice Address - Zip Code:30293-2933
Practice Address - Country:US
Practice Address - Phone:706-672-4974
Practice Address - Fax:706-672-1065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-12
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAD28997251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00005093QMedicaid