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General NPI Number Information
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NPI Number | 1851381156
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Entity Type | Organization
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Legal Business Name | GLYNN COUNTY GEORGIA
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Dates
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Enumeration Date | 10/27/2005
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Last Update Date | 08/15/2024
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Provider Practice Location Address
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Address Line | 121 PUBLIC SAFETY BLVD
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City | BRUNSWICK
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State | GA
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Zip | 31525-8906
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Country | US
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Telephone | 912-554-7779
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Fax | 912-297-3695
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Provider Business Mailing Address
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Address Line | PO BOX 429
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City | LEWISVILLE
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State | NC
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Zip | 27023-0429
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Country | US
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Telephone | 877-200-1191
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Fax | 336-740-9793
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Authorized Official
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Title or Position | ADMINISTRATIVE SUPERVISOR
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Name | TERESA RENEE SHORB
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Credential |
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Telephone | 912-554-7779
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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 | 063-01
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License Number State | GA
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