Provider Demographics
NPI:1568569556
Name:LUMPKIN COUNTY BOARD OF COMMISSIONERS
Entity Type:Organization
Organization Name:LUMPKIN COUNTY BOARD OF COMMISSIONERS
Other - Org Name:LUMPKIN COUNTY EMERGENCY MEDICAL SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF FINANCE & PURCHASING
Authorized Official - Prefix:MRS
Authorized Official - First Name:ABBY
Authorized Official - Middle Name:C
Authorized Official - Last Name:BRANAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-482-2554
Mailing Address - Street 1:PO BOX 5847
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30504-0847
Mailing Address - Country:US
Mailing Address - Phone:706-864-9180
Mailing Address - Fax:706-864-4172
Practice Address - Street 1:57 PINETREE WAY # B
Practice Address - Street 2:
Practice Address - City:DAHLONEGA
Practice Address - State:GA
Practice Address - Zip Code:30533-0819
Practice Address - Country:US
Practice Address - Phone:706-864-9180
Practice Address - Fax:706-864-4172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA093-023416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000081232BMedicaid