NORTHEAST HEALTH DISTRICT - EPSDT COUNTY NPI 1417152505

NPI Information

NPI: 1417152505
Provider Name: NORTHEAST HEALTH DISTRICT - EPSDT COUNTY

Other Name: ELBERT CO HLTH DEPT DIST 10

Classification: Clinic/Center - 261QP0905X
Entity Type: Organization

Specialization: Public Health, State or Local

Address:
618 JONES ST
ELBERTON, GA
ZIP 30635
Phone: (706) 283-3775
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NORTHEAST HEALTH DISTRICT - EPSDT COUNTY is a public health and state or local clinic center in Elberton, GA. NORTHEAST HEALTH DISTRICT - EPSDT COUNTY NPI is 1417152505. The provider is registered as an organization entity type.
The provider Other Name Is Elbert Co Hlth Dept Dist 10.

The provider's business location address is:

618 JONES ST
ELBERTON, GA
ZIP 30635-985
Phone: (706) 283-3775
Fax: (706) 283-7155

The provider's authorized official is Donald S Goggans .
The authorized official title is Health Director and has the following contact phone number (706) 583-2870.

The enumeration date for this NPI number is 6/19/2007 and was last updated on 11/21/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP0905X	Clinic/Center	Public Health, State or Local			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	000051983D	MEDICAID	GEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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