Provider Demographics
NPI:1265597371
Name:FORSYTH COUNTY BOARD OF HEALTH
Entity type:Organization
Organization Name:FORSYTH COUNTY BOARD OF HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AREA NURSE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:L
Authorized Official - Last Name:BAYMILLER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:770-781-6900
Mailing Address - Street 1:428 CANTON RD
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040-2002
Mailing Address - Country:US
Mailing Address - Phone:770-781-6900
Mailing Address - Fax:770-781-6929
Practice Address - Street 1:428 CANTON RD
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-2002
Practice Address - Country:US
Practice Address - Phone:770-781-6900
Practice Address - Fax:770-781-6929
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00479421FMedicaid
GA00456442LMedicaid
GA00442945DMedicaid
GA00051972DMedicaid
GAD31310Medicare UPIN
GA00479421FMedicaid