COFFEE COUNTY BOARD OF HEALTH (NPI# 1316976699) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316976699 |
| Entity Type | Organization |
| Organization Name | COFFEE COUNTY BOARD OF HEALTH |
| Other Organization Name | COFFEE WELLNESS CENTER |
| Practice Address |
1003 Shirley Ave Douglas GA 31533-2123 |
| Practice Telephone | 9123894586 |
| Practice Fax Number | 9133894590 |
| Mailing Telephone | 9123894586 |
| Mailing Fax Number | 9133894590 |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2012-12-11 |
| Authorized Official Name | STARLA SUTTON (PSO) |
| Authorized Official Telephone | 9123385263 |
| Is Organization Subpart | Y |
| Parent Organization Name | COFFEE COUNTY BOARD OF HEALTH |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251K00000X | Public Health or Welfare | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000808387A | 05 | |
| GA | 000955171A | 05 |
| Other Name | Type Code |
|---|---|
| Coffee Wellness Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952346074 | Coffee County Board of Health | Public Health or Welfare | 1111 Baker Hwy W, Douglas, GA 31533-2107 | 2006-06-20 |
| Street Address |
1003 SHIRLEY AVE |
| City | DOUGLAS |
| State | GA |
| Zip Code | 31533-2123 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144849290 | Maria Esmeralda Gomez | Registered Nurse | 1003 Shirley Ave, Douglas, GA 31533-2123 | 2020-04-09 |
| 1154862894 | Regina Ann Stone | Nurse Practitioner | 1003 Shirley Ave, Douglas, GA 31533-2123 | 2017-03-14 |
| 1013941525 | Mary L Humphrey | Registered Nurse | 1003 Shirley Ave, Douglas, GA 31533-2123 | 2006-07-10 |
| 1962433755 | Susan W Bryant | Registered Nurse | 1003 Shirley Ave, Douglas, GA 31533-2123 | 2006-07-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508470964 | Swain Drug Company LLC | Pharmacy | 855 Bowens Mill Rd Sw Suite E, Douglas, GA 31533 | 2020-09-03 |
| 1811528649 | Unison Behavioral Health | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 211 North Street, Douglas, GA 31533 | 2020-01-30 |
| 1952940793 | Teresa Smith | Pharmacist | 901 W Ward St, Douglas, GA 31533 | 2019-12-26 |
| 1447641048 | Jennifer Spivey | Nurse Practitioner | 326 Shirley Avenue, Douglas, GA 31533 | 2015-02-18 |
| 1972914497 | Jessica Lynne Courson | Nurse Practitioner | 903 West Ward Street, Suite B, Douglas, GA 31533 | 2014-05-19 |
| 1063840296 | South Central Primary Care Center | Clinic/Center | 303 Shirley Ave, Ste B, Douglas, GA 31533 | 2013-10-25 |
| 1336411008 | Unison Behavioral Health | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 118 Coweta Avenue South, Douglas, GA 31533 | 2012-01-27 |
| 1346482700 | V and V Clinic | Pediatrics | 1020 West Bryan Street, Douglas, GA 31533 | 2009-04-01 |
| 1063650406 | Jayla Snipes Bullock | Speech-Language Pathologist | 618 Bowens Mill Road Sw, Douglas, GA 31533 | 2009-01-22 |
| 1417112707 | Southern Community Services Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 315 S. Gaskin Ave, Douglas, GA 31533 | 2008-07-25 |
| Find all providers in zip 31533 | ||||
| Taxonomy Code | 251K00000X |
| Grouping | Agencies |
| Classification | Public Health or Welfare |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700442753 | Region Xi Field Fiscal Office | Public Health or Welfare | 1400 Peterson Ave N Ste D, Douglas, GA 31533-2833 | 2019-05-15 |
| 1477982395 | Psa Behavioral Health Agency | Public Health or Welfare | 541 E 10th St, Douglas, AZ 85607-2009 | 2013-11-01 |
| 1316015316 | Southeastern Arizona Behavioral Health Services, Inc. | Public Health or Welfare | 1940 E 11th St, Douglas, AZ 85607-2413 | 2006-11-30 |
| 1255438651 | County of Converse | Public Health or Welfare | 442 Center, Douglas, WY 82633 | 2006-09-20 |
| 1225074685 | Town of Douglas | Public Health or Welfare | 29 Depot St, Douglas, MA 01516-2374 | 2006-06-22 |
| 1952346074 | Coffee County Board of Health | Public Health or Welfare | 1111 Baker Hwy W, Douglas, GA 31533-2107 | 2006-06-20 |
| 1124016019 | Southeastern Arizona Behavioral Health Services, Inc. | Public Health or Welfare | 1701 N Douglas Ave, Douglas, AZ 85607-1019 | 2005-10-13 |
| 1366864423 | Psa Behavioral Health Agency | Public Health or Welfare | 1500 E 15th St, Room 608, Douglas, AZ 85607-1731 | 2014-01-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073136990 | Middle Flint Area Community Service Board | Public Health or Welfare | 106 W Furlow St, Americus, GA 31709-4110 | 2020-05-27 |
| 1023645728 | Emanuel County Board of Health | Public Health or Welfare | 50 Ga Highway 56 N, Swainsboro, GA 30401-4441 | 2020-03-24 |
| 1508498544 | Benard & Romulus LLC | Public Health or Welfare | 917 Revere Way, Hampton, GA 30228-5969 | 2020-02-07 |
| 1770142309 | Region 14 Department of Family and Children Services | Public Health or Welfare | 178 Sams St, Decatur, GA 30030-4134 | 2019-06-07 |
| 1841856242 | Dfcs Region Ix | Public Health or Welfare | 904 Claxton Dairy Rd, Dublin, GA 31021-5423 | 2019-05-13 |
| 1740750181 | Cherokee County Health Department | Public Health or Welfare | 7545 Main St Bldg 100, Woodstock, GA 30188-1615 | 2018-11-28 |
| 1396211694 | Everybody Vs Cancer Foundation | Public Health or Welfare | 5040 Snapfinger Woods Dr Ste 201c, Decatur, GA 30035-4020 | 2018-10-15 |
| 1760963482 | Esther Natacha Lafontant | Public Health or Welfare | 3205 Maple Terrace Drive, Suwanee, GA 30024 | 2018-08-22 |
| 1538652425 | Tiffany Baggett | Public Health or Welfare | 1650 Barnes Mill Rd Apt 223, Marietta, GA 30062-7553 | 2018-06-14 |
| 1578096186 | Wendy Simmons | Public Health or Welfare | 9120 Hannahs Crossing Dr, Gainesville, GA 30506-3945 | 2017-04-10 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on COFFEE COUNTY BOARD OF HEALTH.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.