Provider Demographics
NPI:1780668608
Name:THOMAS COUNTY COMMISSIONERS OF ROADS & REVENUES
Entity Type:Organization
Organization Name:THOMAS COUNTY COMMISSIONERS OF ROADS & REVENUES
Other - Org Name:THOMAS CO EMER MED SERV
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COUNTY MANAGER THOMAS COUNTY
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:STEPHENSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-225-4100
Mailing Address - Street 1:1202 REMINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31792-4835
Mailing Address - Country:US
Mailing Address - Phone:229-225-4114
Mailing Address - Fax:229-226-5268
Practice Address - Street 1:1202 REMINGTON AVE
Practice Address - Street 2:
Practice Address - City:THOMASVILLE
Practice Address - State:GA
Practice Address - Zip Code:31792-4835
Practice Address - Country:US
Practice Address - Phone:229-225-4114
Practice Address - Fax:229-226-5268
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-05
Last Update Date:2013-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA136023416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000003066AMedicaid
GA85034559AAMedicare PIN