Provider Demographics
NPI:1992991160
Name:RICHMOND COUNTY BOARD OF HEALTH
Entity type:Organization
Organization Name:RICHMOND COUNTY BOARD OF HEALTH
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DISTRICT HEALTH DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LEE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:DONOHUE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:706-825-6914
Mailing Address - Street 1:2420 WINDSOR SPRING RD
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30906-4668
Mailing Address - Country:US
Mailing Address - Phone:706-790-2599
Mailing Address - Fax:706-793-5669
Practice Address - Street 1:2420 WINDSOR SPRING RD
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30906-4668
Practice Address - Country:US
Practice Address - Phone:706-790-2599
Practice Address - Fax:706-793-5669
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-20
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000456552QMedicaid
GA547182765AMedicaid
GA000058572BMedicaid
GA547182765AMedicaid
GAFLU104Medicare PIN