Provider Demographics
NPI:1699855049
Name:BURKE COUNTY BOARD OF COMMISSIONERS
Entity Type:Organization
Organization Name:BURKE COUNTY BOARD OF COMMISSIONERS
Other - Org Name:BURKE COUNTY EMERGENCY MANAGEMENT AGENCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RUSTY
Authorized Official - Middle Name:
Authorized Official - Last Name:SANDERS
Authorized Official - Suffix:
Authorized Official - Credentials:PARAMEDIC
Authorized Official - Phone:706-554-6651
Mailing Address - Street 1:277 GA HIGHWAY 24 S
Mailing Address - Street 2:
Mailing Address - City:WAYNESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30830-4579
Mailing Address - Country:US
Mailing Address - Phone:706-554-6651
Mailing Address - Fax:706-554-4660
Practice Address - Street 1:277 GA HIGHWAY 24 S
Practice Address - Street 2:
Practice Address - City:WAYNESBORO
Practice Address - State:GA
Practice Address - Zip Code:30830-4579
Practice Address - Country:US
Practice Address - Phone:706-554-6651
Practice Address - Fax:706-554-4660
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BURKE COUNTY BOARD OF COMMISSIONERS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-17
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA017-013416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00002527AMedicaid
GA00002527AMedicaid