Provider Demographics
NPI:1457428963
Name:PULASKI COUNTY HEALTH DEPARTMENT
Entity type:Organization
Organization Name:PULASKI COUNTY HEALTH DEPARTMENT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CANDACE
Authorized Official - Middle Name:SPICER
Authorized Official - Last Name:CHRISTIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-375-6545
Mailing Address - Street 1:PO BOX 480
Mailing Address - Street 2:
Mailing Address - City:HAWKINSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31036-0480
Mailing Address - Country:US
Mailing Address - Phone:478-783-1361
Mailing Address - Fax:478-892-8362
Practice Address - Street 1:81 N LUMPKIN ST
Practice Address - Street 2:
Practice Address - City:HAWKINSVILLE
Practice Address - State:GA
Practice Address - Zip Code:31036-4721
Practice Address - Country:US
Practice Address - Phone:478-783-1361
Practice Address - Fax:478-892-8362
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2011-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare