Provider Demographics
NPI:1912091661
Name:TROUP COUNTY BOARD OF HEALTH
Entity type:Organization
Organization Name:TROUP COUNTY BOARD OF HEALTH
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BILLING SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:KYLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MYHAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-298-7709
Mailing Address - Street 1:301 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LAGRANGE
Mailing Address - State:GA
Mailing Address - Zip Code:30240-4503
Mailing Address - Country:US
Mailing Address - Phone:800-847-4262
Mailing Address - Fax:706-298-6373
Practice Address - Street 1:301 MAIN ST
Practice Address - Street 2:
Practice Address - City:LAGRANGE
Practice Address - State:GA
Practice Address - Zip Code:30240-4503
Practice Address - Country:US
Practice Address - Phone:800-847-4262
Practice Address - Fax:706-298-6373
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TROUP COUNTY BOARD OF HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-03
Last Update Date:2025-12-01
Deactivation Date:2023-09-13
Deactivation Code:
Reactivation Date:2025-11-20
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local
No251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000644872BMedicaid
GA000548303AMedicaid
GA000644872BMedicaid