1265787444 NPI number — LUMPKIN COUNTY EMERGENCY MEDICAL SERVICES

Table of content: (NPI 1265787444)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265787444 NPI number — LUMPKIN COUNTY EMERGENCY MEDICAL SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LUMPKIN COUNTY EMERGENCY MEDICAL SERVICES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1265787444
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/04/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 5847
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GAINESVILLE
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30504-0847
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
706-864-3030
Provider Business Mailing Address Fax Number:
706-867-9099

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
57A PINE TREE WAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DAHLONEGA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30533
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
706-864-3030
Provider Business Practice Location Address Fax Number:
706-867-9099
Provider Enumeration Date:
07/13/2012

Additional Information

Authorized Official

Authorized Official Last Name:
BRANAN
Authorized Official First Name:
ABBY
Authorized Official Middle Name:
C
Authorized Official Title or Position:
DIRECTOR OF FINANCE & PURCHASING
Authorized Official Telephone Number:
706-482-2554

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  093-02 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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