MEDICARE: HARRIS COUNTY COMMISSIONER OF ROADS & REVENUES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3416L0300X	Land Ambulance	072-02	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1881780799
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HARRIS COUNTY COMMISSIONER OF ROADS & REVENUES

Provider Business Mailing Address
First Line	:	PO BOX 365
Second Line	:
City	:	HAMILTON
State	:	GA
Zip	:	31811-0365
Country	:	US
Telephone Number	:	706-628-4284
Fax Number	:

Provider Business Practice Location Address
First Line	:	9907 HWY 116
Second Line	:
City	:	HAMILTON
State	:	GA
Zip	:	31811
Country	:	US
Telephone Number	:	706-628-4284
Fax Number	:

Authorized Official
Title or Position	:	CHIEF
Name	:	MR. DAVID MCCALL
Credential	:
Telephone Number	:	706-628-4284

Provider Enumeration Date	:	10/05/2006
Last Update Date	:	02/11/2013

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