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General NPI Number Information
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NPI Number | 1104835164
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Entity Type | Organization
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Legal Business Name | MADISON CO COMMISSIONER ROADS AND REVENUE
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Dates
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Enumeration Date | 08/07/2006
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Last Update Date | 05/23/2008
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Provider Practice Location Address
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Address Line | HWY 98 W
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City | DANIELSVILLE
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State | GA
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Zip | 30633
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Country | US
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Telephone | 706-795-6300
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Fax | 706-795-2980
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Provider Business Mailing Address
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Address Line | 91 ALBANY AVE
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City | DANIELSVILLE
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State | GA
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Zip | 30633
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Country | US
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Telephone | 706-795-6300
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Fax | 706-795-2980
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Authorized Official
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Title or Position | BILLING SPECIALIST
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Name | CHERRI MAE WYATT
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Credential |
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Telephone | 706-795-6307
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 09501
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License Number State | GA
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