Organization
LIBERTY COUNTY BOARD OF HEALTH
Active
Other names
Coastal Health District-Brunswick
Organization subpart
No
Provider details
NPI number
Authorized official
STACY A. COOPER (DISTRICT BILLING DEPT. COORDINATOR)
(912) 262-2347
Entity
Organization
Contact information
Practice address
1113 E OGLETHORPE HWY, HINESVILLE, GA 31313-1200
(912) 876-2173
(912) 368-8033
Mailing address
150 SCRANTON CONNECTOR, BRUNSWICK, GA 31525-0540
(912) 262-2347
(912) 262-3036
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000051818E
—
GA
05
—
000453219C
—
GA
05
—
000456508K
—
GA
05
—
000456508U
—
GA
05
—
000457938D
—
GA
05
—
000551889A
—
GA
01
—
FLU146
MEDICARE ID
GA
Enumeration date
11/28/2005
Last updated
01/06/2015
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