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General NPI Number Information
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NPI Number | 1801972625
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Entity Type | Organization
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Legal Business Name | CHEROKEE COUNTY BOARD OF COMMISSIONERS
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Dates
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Enumeration Date | 10/27/2006
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Last Update Date | 04/17/2013
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Provider Practice Location Address
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Address Line | 150 CHATTIN DR
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City | CANTON
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State | GA
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Zip | 30115-8249
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Country | US
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Telephone | 678-614-8957
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Fax |
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Provider Business Mailing Address
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Address Line | N2930 STATE ROAD 22
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City | WAUTOMA
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State | WI
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Zip | 54982-5267
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Country | US
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Telephone | 920-787-2291
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Fax |
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Authorized Official
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Title or Position | CHIEF
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Name | DAN WEST
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Credential |
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Telephone | 678-614-8957
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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 | 028-03
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License Number State | GA
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