Appling County Board of Health

Organization Active NPI Public Health or Welfare Agency · Baxley, GA

NPI 1174568372 · NPPES record last updated May 30, 2013

Key facts

NPI
1174568372
Entity type
Organization (NPI type 2)
Primary specialty
Public Health or Welfare Agency 251K00000X
Legal business name
APPLING COUNTY BOARD OF HEALTH
Practice address
34 Walnut St
Baxley, GA 31513-0119
Phone
(912) 367-4601
Fax
(912) 367-1096
NPI assigned
Jun 19, 2006
Organization subpart
No

Authorized official

Name
Mrs. Starla Sutton
Title
Pso
Phone
(912) 427-2042

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in GA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20130529000488 GA Part B Supplier - Mass Immunization (Roster Biller Only) 8325080054 Practice locations: Baxley, GA

National Provider Directory

Locations

283 Walnut St
Baxley, GA 31513
Phone (855) 473-4374

201 Walnut St
Baxley, GA 31513
Phone (912) 367-4601

201 Walnut St
Baxley, GA 31513
Phone (912) 367-4601

34 Walnut St
Baxley, GA 31513
Phone (912) 367-4601

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X Yes

Addresses

Primary practice location

34 Walnut St
Baxley, GA 31513-0119

Mailing address

PO Box 37
Baxley, GA 31515-0037
Phone (912) 367-4601

Other identifiers

IdentifierTypeStateIssuer
000442967BMedicaidGA
000611619AMedicaidGA
000453098AMedicaidGA
000052027BMedicaidGA
000457784AMedicaidGA

Other providers in Baxley, GA

All providers in Baxley, GA · Public Health or Welfare Agency in Georgia

Sources for this page

Verify at the official NPI Registry.