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General NPI Number Information
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NPI Number | 1396788097
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Entity Type | Organization
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Legal Business Name | WILKES COUNTY BOARD OF COMMISSIONERS
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Dates
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Enumeration Date | 06/13/2006
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Last Update Date | 03/11/2013
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Provider Practice Location Address
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Address Line | 105 MARSHALL STREET
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City | WASHINGTON
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State | GA
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Zip | 30673
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Country | US
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Telephone | 706-678-7837
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Fax |
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Provider Business Mailing Address
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Address Line | 105 MARSHALL STREET
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City | WASHINGTON
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State | GA
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Zip | 30673
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Country | US
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Telephone | 706-678-7837
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Fax |
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Authorized Official
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Title or Position | OPERATIONS MANAGER
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Name | MRS. TINA BAGWELL BAILEY
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Credential | PARAMEDIC
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Telephone | 706-678-7837
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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 | 157-02
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License Number State | GA
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