Laurens County Board of Health
Organization Active NPI Public Health or Welfare Agency · Dublin, GA
NPI 1841505641 · NPPES record last updated Nov 23, 2022
Key facts
- NPI
- 1841505641
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Public Health or Welfare Agency 251K00000X
- Legal business name
- LAURENS COUNTY BOARD OF HEALTH
- Practice address
- 103 Mercer Dr Ste B
Dublin, GA 31021-4257 - Phone
- (478) 274-7949
- Fax
- (478) 274-7948
- NPI assigned
- Aug 17, 2010
- Organization subpart
- Yes
- Parent organization (as reported)
- LAURENS COUNTY BOARD OF HEALTH
Authorized official
- Name
- Michelle Mullis
- Title
- Administrator
- Phone
- (478) 275-6563
Other NPIs with the same Medicare PAC ID 1
Corporate family (same tax ID) 4
Practitioners 13
-
Andrew Wen-Han Chao, M.D.
-
Shelia S Payne, APRN
-
Jose A. Vazquez, M.D.
-
Gina Askar, MD
-
Whitney S Moss, MSW
-
April S Phillips, BSHA
-
Angela Michelle Street, RDN, LD
-
Thomas E Craft, M.D.
-
Gwendolyn T Edmond, LPC
-
Stacey Upshaw, RN MSN
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20131212001278 | GA | Part B Supplier - Clinic/Group Practice | 9739356635 |
Receives reassigned benefits from 5 practitioners Practice locations: Dublin, GA |
National Provider Directory
- Tax ID family
- Laurens County Health D
- Part of
- Laurens County Health D
Locations
105 E Jackson St
Dublin, GA 31021
2121 Bellevue Rd
Dublin, GA 31021
Phone (478) 272-2051
2121 Bellevue Rd
#B
Dublin, GA 31021
230 Industrial Blvd
Ste C
Dublin, GA 31021
Phone (478) 274-3012
2121B Bellevue Rd
Dublin, GA 31021
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Public Health or Welfare Agency | 251K00000X | Yes |
Addresses
Primary practice location
103 Mercer Dr Ste B
Dublin, GA 31021-4257
Mailing address
105 E Jackson St
Dublin, GA 31021-6113
Phone (478) 275-6563
Other names
- Ryan White Clinic
Other providers in Dublin, GA
- Laurens County Baord of Health
- Laurens County Board of Education
- Laurens County Board of Health
- Laurens County Board of Health
- Laurens County Board of Health
- Laurens County Volunteers in Medicine
- Laurens Internal Medicine
- Laurens Pediatrics, LLC
- Tara Hutchinson Lausch
- Brianna Law
All providers in Dublin, GA · Public Health or Welfare Agency in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 23, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.