Provider Demographics
NPI:1487878575
Name:COBB COUNTY BOARD OF HEALTH
Entity type:Organization
Organization Name:COBB COUNTY BOARD OF HEALTH
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST-IN-CHARGE (PIC)
Authorized Official - Prefix:DR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:E
Authorized Official - Last Name:ALLGOOD
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD, RPH
Authorized Official - Phone:770-514-2345
Mailing Address - Street 1:1650 COUNTY SERVICES PKWY SW
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30008-4010
Mailing Address - Country:US
Mailing Address - Phone:770-514-2350
Mailing Address - Fax:770-514-2393
Practice Address - Street 1:1650 COUNTY SERVICES PKWY SW
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30008-4010
Practice Address - Country:US
Practice Address - Phone:770-514-2350
Practice Address - Fax:770-514-2393
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0003X
GA56533336I0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336I0012XSuppliersPharmacyInstitutional Pharmacy