Healthcare Provider Details

I. General information

NPI: 1992734867
Provider Name (Legal Business Name): HALL COUNTY GEORGIA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2006
Last Update Date: 09/25/2024
Certification Date: 09/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

470 CRESCENT DR
GAINESVILLE GA
30501-5079
US

IV. Provider business mailing address

PO BOX 931136
ATLANTA GA
31193-1136
US

V. Phone/Fax

Practice location:
  • Phone: 770-531-6835
  • Fax: 770-531-6845
Mailing address:
  • Phone: 770-531-6838
  • Fax: 770-531-6845

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number06907
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code341800000X
TaxonomyMilitary/U.S. Coast Guard Transport
License Number06907
License Number StateGA

VIII. Authorized Official

Name: CHRISTIE GRICE
Title or Position: DIVISION CHIEF OF EMS
Credential:
Phone: 770-531-6838