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General NPI Number Information
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NPI Number | 1912143207
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Entity Type | Organization
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Legal Business Name | WALKER COUNTY EMERGENCY SERVICES
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Dates
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Enumeration Date | 12/17/2008
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Last Update Date | 01/05/2012
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Provider Practice Location Address
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Address Line | 107 ALEX DR
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City | CHICKAMAUGA
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State | GA
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Zip | 30707-4154
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Country | US
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Telephone | 706-539-1255
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 130
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City | CHICKAMAUGA
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State | GA
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Zip | 30707-0130
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | COUNTY COORDINATOR
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Name | DAVID ASHBURN
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Credential |
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Telephone | 706-375-5601
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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 | 146-10
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License Number State | GA
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