Healthcare Provider Details

I. General information

NPI: 1316052566
Provider Name (Legal Business Name): GWINNETT COUNTY BOARD OF COMMISSIONERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2006
Last Update Date: 12/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

408 HURRICANE SHOALS RD NE
LAWRENCEVILLE GA
30046-4406
US

IV. Provider business mailing address

408 HURRICANE SHOALS RD NE
LAWRENCEVILLE GA
30046-4406
US

V. Phone/Fax

Practice location:
  • Phone: 678-518-4950
  • Fax: 678-518-4951
Mailing address:
  • Phone: 678-518-4950
  • Fax: 678-518-4951

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number06707
License Number StateGA

VIII. Authorized Official

Name: BRIAN WOLFE
Title or Position: ASSISTANT CHIEF - BUSINESS SERVICES
Credential:
Phone: 678-518-4832