Provider Demographics
NPI:1942257738
Name:RABUN COUNTY BOARD OF HEALTH
Entity Type:Organization
Organization Name:RABUN COUNTY BOARD OF HEALTH
Other - Org Name:RABUN COUNTY HEALTH DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:V
Authorized Official - Last Name:SHOOK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-212-0289
Mailing Address - Street 1:19 JO DOTSON CIR
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:GA
Mailing Address - Zip Code:30525-5007
Mailing Address - Country:US
Mailing Address - Phone:706-212-0289
Mailing Address - Fax:706-212-0296
Practice Address - Street 1:19 JO DOTSON CIR
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:GA
Practice Address - Zip Code:30525-5007
Practice Address - Country:US
Practice Address - Phone:706-212-0289
Practice Address - Fax:706-212-0296
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA7656144HK251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00453109JMedicaid
GA00769062DMedicaid
GA00051972JMedicaid
GA00442945KMedicaid
GA00058638AMedicaid
GA00456442EMedicaid
GA00442945KMedicaid