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General NPI Number Information
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NPI Number | 1750443941
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Entity Type | Organization
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Legal Business Name | DECATUR COUNTY BOARD OF COMMISSIONERS
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Dates
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Enumeration Date | 12/14/2006
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Last Update Date | 02/22/2013
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Provider Practice Location Address
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Address Line | 307 AIRPORT RD
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City | BAINBRIDGE
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State | GA
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Zip | 39817-6898
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Country | US
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Telephone | 229-248-3001
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Fax | 229-248-3003
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Provider Business Mailing Address
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Address Line | PO BOX 726
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City | BAINBRIDGE
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State | GA
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Zip | 39818-0726
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Country | US
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Telephone | 229-248-3001
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Fax | 229-248-3003
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Authorized Official
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Title or Position | DEPUTY EMS CHIEF
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Name | LARRY L BATTLE
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Credential |
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Telephone | 229-248-3001
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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 | 043-05
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number |
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License Number State |
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