Provider Demographics
NPI:1609064567
Name:GLADES COUNTY BOARD OF COUNTY COMMISSIONERS - EMS
Entity Type:Organization
Organization Name:GLADES COUNTY BOARD OF COUNTY COMMISSIONERS - EMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN OF GCBOCC
Authorized Official - Prefix:MR
Authorized Official - First Name:KS 'BUTCH'
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:863-946-6020
Mailing Address - Street 1:PO BOX 481
Mailing Address - Street 2:
Mailing Address - City:MOORE HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33471-0481
Mailing Address - Country:US
Mailing Address - Phone:863-946-6020
Mailing Address - Fax:863-946-1091
Practice Address - Street 1:500 AVENUE J
Practice Address - Street 2:
Practice Address - City:MOORE HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33471
Practice Address - Country:US
Practice Address - Phone:863-946-6020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-04
Last Update Date:2007-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL27763416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLA8936Medicare PIN