Provider Demographics
NPI:1952463192
Name:SOUTH HEALTH DISTRICT
Entity Type:Organization
Organization Name:SOUTH HEALTH DISTRICT
Other - Org Name:LANIER COUNTY BOARD OF HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DISTRICT ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SHERRIE
Authorized Official - Middle Name:B
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-245-6439
Mailing Address - Street 1:PO BOX 5147
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31603-5147
Mailing Address - Country:US
Mailing Address - Phone:229-333-5290
Mailing Address - Fax:229-333-7822
Practice Address - Street 1:205 W MURRELL AVE
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:GA
Practice Address - Zip Code:31635-2103
Practice Address - Country:US
Practice Address - Phone:229-482-3294
Practice Address - Fax:229-482-2006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA338796OtherWELLCARE
GAFLU 210Medicare ID - Type UnspecifiedLANIER FLU