Provider Demographics
NPI:1093782732
Name:CAMDEN COUNTY COMMISSIONER OF
Entity Type:Organization
Organization Name:CAMDEN COUNTY COMMISSIONER OF
Other - Org Name:CAMDEN COUNTY FIRE RESCUE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:PARSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-729-1056
Mailing Address - Street 1:PO BOX 9150
Mailing Address - Street 2:
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42002-9150
Mailing Address - Country:US
Mailing Address - Phone:270-744-9600
Mailing Address - Fax:270-744-8642
Practice Address - Street 1:125 N GROSS RD
Practice Address - Street 2:
Practice Address - City:KINGSLAND
Practice Address - State:GA
Practice Address - Zip Code:31548-6237
Practice Address - Country:US
Practice Address - Phone:912-729-1056
Practice Address - Fax:912-729-6527
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-01
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA020-013416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000002791AMedicaid
GA407590174Medicare PIN
GA85030559AAMedicare ID - Type Unspecified
GA000002791AMedicaid