Healthcare Provider Details

I. General information

NPI: 1093782732
Provider Name (Legal Business Name): CAMDEN COUNTY COMMISSIONER OF
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2006
Last Update Date: 03/27/2024
Certification Date: 07/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 N GROSS RD
KINGSLAND GA
31548-6237
US

IV. Provider business mailing address

PO BOX 9150
PADUCAH KY
42002-9150
US

V. Phone/Fax

Practice location:
  • Phone: 912-729-1056
  • Fax: 912-729-6527
Mailing address:
  • Phone: 270-744-9600
  • Fax: 270-744-8642

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number020-01
License Number StateGA

VIII. Authorized Official

Name: MR. PATRICK PARSON
Title or Position: DIRECTOR
Credential:
Phone: 912-729-1056