MEDICARE: SUWANNEE COUNTY BOARD OF COUNTY COMMISSIONERS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3416L0300X	Land Ambulance	3603	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1427087717
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUWANNEE COUNTY BOARD OF COUNTY COMMISSIONERS

Provider Business Mailing Address
First Line	:	13530 80TH TERRACE
Second Line	:
City	:	LIVE OAK
State	:	FL
Zip	:	32060-8868
Country	:	US
Telephone Number	:	386-364-3404
Fax Number	:	386-364-1256

Provider Business Practice Location Address
First Line	:	13530 80TH TERRACE
Second Line	:
City	:	LIVE OAK
State	:	FL
Zip	:	32060
Country	:	US
Telephone Number	:	386-364-3404
Fax Number	:	386-364-1256

Authorized Official
Title or Position	:	PUBLIC SAFETY DIRECTOR
Name	:	JAMES E SOMMERS
Credential	:
Telephone Number	:	386-364-3404

Provider Enumeration Date	:	07/01/2006
Last Update Date	:	06/05/2018

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Directions to “SUWANNEE COUNTY BOARD OF COUNTY COMMISSIONERS ” Practice Location

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