Provider Demographics
NPI:1922051002
Name:LINCOLN COUNTY BOARD OF HEALTH
Entity Type:Organization
Organization Name:LINCOLN COUNTY BOARD OF HEALTH
Other - Org Name:LINCOLN COUNTY HEALTH DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DISTRICT BILLING SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:C
Authorized Official - Last Name:NEWTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-667-4265
Mailing Address - Street 1:1916 N LEG RD
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30909-4402
Mailing Address - Country:US
Mailing Address - Phone:706-667-4265
Mailing Address - Fax:706-667-4301
Practice Address - Street 1:176 NORTH PEACHTREE ST
Practice Address - Street 2:
Practice Address - City:LINCOLNTON
Practice Address - State:GA
Practice Address - Zip Code:30817
Practice Address - Country:US
Practice Address - Phone:706-359-3154
Practice Address - Fax:706-359-1939
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000051851HMedicaid
GAP00124765OtherMEDICARE RAILROAD
GA000866137AMedicaid
GA000676563FMedicaid
GA000456552KMedicaid
GA000573405AMedicaid
GA000676563FMedicaid