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General NPI Number Information
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NPI Number | 1801912597
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Entity Type | Organization
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Legal Business Name | FANNIN COUNTY BOARD OF COMMISSIONERS
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Dates
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Enumeration Date | 03/22/2007
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Last Update Date | 04/02/2020
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Provider Practice Location Address
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Address Line | 20 STATION RIDGE
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City | BLUE RIDGE
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State | GA
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Zip | 30513-0058
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Country | US
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Telephone | 706-632-4755
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Fax | 706-632-3818
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Provider Business Mailing Address
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Address Line | 20 STATION RIDGE
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City | BLUE RIDGE
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State | GA
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Zip | 30513-0058
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Country | US
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Telephone | 706-632-4755
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Fax | 706-632-3818
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Authorized Official
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Title or Position | EMA EMS DIRECTOR
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Name | MR. ROBERT GRAHAM
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Credential |
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Telephone | 706-632-1958
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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 | 055-03
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License Number State | GA
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