MEDICARE: COUNTY OF MADISON OFFICE CLERK BOARD 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	341600000X	Ambulance	002557	FL
2	341600000X	Ambulance
3	3416L0300X	Land Ambulance

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	:	1700865870
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COUNTY OF MADISON OFFICE CLERK BOARD COUNTY COMMISSIONERS

Provider Business Mailing Address
First Line	:	PO BOX 237
Second Line	:
City	:	MADISON
State	:	FL
Zip	:	32341-0237
Country	:	US
Telephone Number	:	850-973-1494
Fax Number	:	850-973-4157

Provider Business Practice Location Address
First Line	:	1314 W BASE ST
Second Line	:
City	:	MADISON
State	:	FL
Zip	:	32340-1416
Country	:	US
Telephone Number	:	850-973-1494
Fax Number	:	850-973-4157

Authorized Official
Title or Position	:	FIRE CHIEF
Name	:	CHARLES A CLAYTON
Credential	:
Telephone Number	:	850-464-7586

Provider Enumeration Date	:	01/17/2006
Last Update Date	:	10/20/2020

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