BRANTLEY COUNTY BOARD OF HEALTH NPI 1730116120

NPI Information

NPI: 1730116120
Provider Name: BRANTLEY COUNTY BOARD OF HEALTH
Classification: Public Health or Welfare - 251K00000X
Entity Type: Organization

CLIA Number: 11D2200411

Address:
173 FLORIDA AVENUE
NAHUNTA, GA
ZIP 31553
Phone: (912) 462-6165
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BRANTLEY COUNTY BOARD OF HEALTH is a public health or welfare in Nahunta, GA. BRANTLEY COUNTY BOARD OF HEALTH NPI is 1730116120. The provider is registered as an organization entity type.

The provider's business location address is:

173 FLORIDA AVENUE
NAHUNTA, GA
ZIP 31553-053
Phone: (912) 462-6165
Fax: (912) 462-7655

The provider's authorized official is Starla Sutton .
The authorized official title is Pso and has the following contact phone number (912) 427-2042.

The CLIA number assigned to this NPI record is 11D2200411 - other - jail with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/28/2006 and was last updated on 12/6/2012.

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	251K00000X	Public Health or Welfare				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	000457784D	MEDICAID	GEORGIA
2	000777774A	MEDICAID	GEORGIA
3	FLU121	MEDICARE ID-TYPE UNSPECIFIED	GEORGIA	COUNTY FLU BILLING #
4	000453098D	MEDICAID	GEORGIA
5	GRP3494	MEDICARE ID-TYPE UNSPECIFIED	GEORGIA	COUNTY MDCR BILLING #
6	600002575	MEDICARE ID-TYPE UNSPECIFIED	GEORGIA	RAILROAD BILLING #
7	000052027E	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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