Healthcare Provider Details

I. General information

NPI: 1184614208
Provider Name (Legal Business Name): OFFICE OF GILMER COUNTY COMMISSIONERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2005
Last Update Date: 02/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 HOWARD SIMMONS RD
ELLIJAY GA
30540-6449
US

IV. Provider business mailing address

325 HOWARD SIMMONS RD
ELLIJAY GA
30540-6449
US

V. Phone/Fax

Practice location:
  • Phone: 706-635-1333
  • Fax: 706-635-1334
Mailing address:
  • Phone: 706-635-1333
  • Fax: 706-635-1334

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number061-01
License Number StateGA

VIII. Authorized Official

Name: SANDRA T HOLDEN
Title or Position: FINANCIAL OFFICER
Credential:
Phone: 706-635-4361