1003814278 NPI number — CHATHAM COUNTY BOARD OF HEALTH

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003814278 NPI number — CHATHAM COUNTY BOARD OF HEALTH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHATHAM COUNTY BOARD OF HEALTH
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1003814278
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2011 EISENHOWER DR
Provider Second Line Business Mailing Address:
P.O. BOX 14257
Provider Business Mailing Address City Name:
SAVANNAH
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
31406-3905
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
912-356-2233
Provider Business Mailing Address Fax Number:
912-356-2868

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2011 EISENHOWER DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAVANNAH
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
31406-3905
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
912-356-2233
Provider Business Practice Location Address Fax Number:
912-356-2868
Provider Enumeration Date:
07/12/2005

Additional Information

Authorized Official

Authorized Official Last Name:
SKELTON
Authorized Official First Name:
WILLIAM
Authorized Official Middle Name:
DOUGLAS
Authorized Official Title or Position:
DIRECTOR OF COASTAL HEALTH DISTRICT
Authorized Official Telephone Number:
912-644-5210

Provider Taxonomy Codes

  • Taxonomy code: 251K00000X , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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