Provider Demographics
NPI:1740340322
Name:FLOYD COUNTY BOARD OF HEALTH
Entity type:Organization
Organization Name:FLOYD COUNTY BOARD OF HEALTH
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:C
Authorized Official - Middle Name:WADE
Authorized Official - Last Name:WADE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:706-295-6704
Mailing Address - Street 1:1305 REDMOND CIR NW
Mailing Address - Street 2:BLD-614
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30165-1345
Mailing Address - Country:US
Mailing Address - Phone:706-295-6704
Mailing Address - Fax:706-802-5435
Practice Address - Street 1:16 E 12TH ST SW
Practice Address - Street 2:SUTE 200
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30161-4720
Practice Address - Country:US
Practice Address - Phone:706-802-5372
Practice Address - Fax:706-802-5375
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local