Provider Demographics
NPI:1962461178
Name:BANKS COUNTY HEALTH DEPARTMENT
Entity Type:Organization
Organization Name:BANKS COUNTY HEALTH DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTH DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:N
Authorized Official - Last Name:WESTFALL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-535-5743
Mailing Address - Street 1:667 THOMPSON ST
Mailing Address - Street 2:
Mailing Address - City:HOMER
Mailing Address - State:GA
Mailing Address - Zip Code:30547-3110
Mailing Address - Country:US
Mailing Address - Phone:706-677-2296
Mailing Address - Fax:706-677-4042
Practice Address - Street 1:667 THOMPSON ST
Practice Address - Street 2:
Practice Address - City:HOMER
Practice Address - State:GA
Practice Address - Zip Code:30547-3110
Practice Address - Country:US
Practice Address - Phone:706-677-2296
Practice Address - Fax:706-677-4042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-17
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
GA00442945BMedicaid
GA00479751EMedicaid
GA00051972BMedicaid
GA00456442NMedicaid
GA00595977JMedicaid
GA00051972BMedicaid