Tattnall County Board of Health

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

NPI 1770528804 · NPPES record last updated Aug 19, 2011

Key facts

NPI
1770528804
Entity type
Organization (NPI type 2)
Primary specialty
Public Health or Welfare Agency 251K00000X
Legal business name
TATTNALL COUNTY BOARD OF HEALTH
Practice address
1000 N Veterans Blvd
Glennville, GA 30427-8603
Phone
(912) 654-5290
Fax
(912) 654-5293
NPI assigned
Jun 20, 2006
Organization subpart
Yes
Parent organization (as reported)
TATTNALL COUNTY BOARD OF HEALTH

Authorized official

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

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in GA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20151105001123 GA Part B Supplier - Mass Immunization (Roster Biller Only) 6800837493 1 other NPI on this enrollment
Practice locations: Glennville, GA; Reidsville, GA

National Provider Directory

Part of
Tattnal County Health D

Specialties & licenses

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

Addresses

Primary practice location

1000 N Veterans Blvd
Glennville, GA 30427-8603

Mailing address

PO Box 353
Glennville, GA 30427-0353
Phone (912) 654-5290

Other identifiers

IdentifierTypeStateIssuer
000457784OMedicaidGA
000052027XMedicaidGA
000770648BMedicaidGA
000453098PMedicaidGA
000442967QMedicaidGA

Other names

  • Tattnall County Health Department-Glennville Doing business as

Other providers in Glennville, GA

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

Sources for this page

Verify at the official NPI Registry.