Provider Demographics
NPI:1013967728
Name:EMANUEL COUNTY BOARD OF HEALTH
Entity Type:Organization
Organization Name:EMANUEL COUNTY BOARD OF HEALTH
Other - Org Name:EMANUEL 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 1:50 HIGHWAY 56 N
Mailing Address - Street 2:PO BOX 436
Mailing Address - City:SWAINSBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30401-4441
Mailing Address - Country:US
Mailing Address - Phone:478-237-7501
Mailing Address - Fax:478-289-2501
Practice Address - Street 1:50 HIGHWAY 56 N
Practice Address - Street 2:
Practice Address - City:SWAINSBORO
Practice Address - State:GA
Practice Address - Zip Code:30401-4441
Practice Address - Country:US
Practice Address - Phone:478-237-7501
Practice Address - Fax:478-289-2501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-11
Last Update Date:2020-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000481775HMedicaid
GA000453153DMedicaid
GA000456552GMedicaid
GA000481775IMedicaid
GA000051851DMedicaid
GA000456552UMedicaid
GA000481775EMedicaid
GA000481775CMedicaid
GA000481775AMedicaid
GA000481775GMedicaid
GA000481775JMedicaid
GA000676563CMedicaid
GA000573372AMedicaid
GA000481775BMedicaid
GA000481775FMedicaid
GA000481775IMedicaid