Healthcare Provider Details

I. General information

NPI: 1386752277
Provider Name (Legal Business Name): BOARD OF COMMISSIONERS MILLER COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2006
Last Update Date: 04/03/2023
Certification Date: 04/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

159 E MAIN ST
COLQUITT GA
39837-3611
US

IV. Provider business mailing address

304 W PINE ST
COLQUITT GA
39837-3501
US

V. Phone/Fax

Practice location:
  • Phone: 229-758-4104
  • Fax: 229-758-2229
Mailing address:
  • Phone: 229-758-4104
  • Fax: 229-758-2229

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number100-01
License Number StateGA

VIII. Authorized Official

Name: DEBORAH H PEARCE
Title or Position: COUNTY CLERK
Credential:
Phone: 229-758-4104