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General NPI Number Information
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NPI Number | 1427037522
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Entity Type | Organization
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Legal Business Name | COUNTY OF BANKS
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Dates
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Enumeration Date | 01/17/2006
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Last Update Date | 11/18/2011
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Provider Practice Location Address
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Address Line | 150 HUDSON RDG STE 1
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City | HOMER
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State | GA
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Zip | 30547-3125
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Country | US
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Telephone | 706-335-0123
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Fax | 706-335-0123
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Provider Business Mailing Address
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Address Line | 150 HUDSON RDG STE 1
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City | HOMER
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State | GA
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Zip | 30547-3125
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Country | US
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Telephone | 706-335-0123
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Fax | 706-335-0123
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Authorized Official
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Title or Position | EMERGENCY BILLING LLC
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Name | MS. DONNA D GAILEY
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Credential | OWNER
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Telephone | 706-335-0123
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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 | 006-001
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License Number State | GA
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