MITCHELL COUNTY BOARD OF HEALTTH NPI 1184615122

NPI Information

NPI: 1184615122
Provider Name: MITCHELL COUNTY BOARD OF HEALTTH
Classification: Public Health or Welfare - 251K00000X
Entity Type: Organization

CLIA Number: 11D2191979

Address:
88 W OAKLAND AVE
CAMILLA, GA
ZIP 31730
Phone: (229) 336-2055
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MITCHELL COUNTY BOARD OF HEALTTH is a public health or welfare in Camilla, GA. MITCHELL COUNTY BOARD OF HEALTTH NPI is 1184615122. The provider is registered as an organization entity type.

The provider's business location address is:

88 W OAKLAND AVE
CAMILLA, GA
ZIP 31730-254
Phone: (229) 336-2055
Fax: (229) 336-1100

The provider's authorized official is Charles D Ruis .
The authorized official title is District Health Director and has the following contact phone number (229) 352-4275.

The CLIA number assigned to this NPI record is 11D2191979 - skilled nursing facility/nursing facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/31/2005 and was last updated on 10/23/2017.

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			GEORGIA	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	00452933O	MEDICAID	GEORGIA
2	600000781	MEDICARE ID-TYPE UNSPECIFIED	GEORGIA	RR MEDICARE
3	00738196A	MEDICAID	GEORGIA
4	00052049K	MEDICAID	GEORGIA
5	FLU225	MEDICARE ID-TYPE UNSPECIFIED	GEORGIA	FLU BILLING
6	00456475J	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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