Provider Demographics
NPI:1780675942
Name:COUNTY OF GILES
Entity Type:Organization
Organization Name:COUNTY OF GILES
Other - Org Name:GILES COUNTY AMBULANCE SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROY
Authorized Official - Middle Name:D
Authorized Official - Last Name:GRIGGS
Authorized Official - Suffix:
Authorized Official - Credentials:DIRECTOR
Authorized Official - Phone:931-363-8504
Mailing Address - Street 1:PO BOX 678
Mailing Address - Street 2:
Mailing Address - City:PULASKI
Mailing Address - State:TN
Mailing Address - Zip Code:38478-0678
Mailing Address - Country:US
Mailing Address - Phone:931-363-8504
Mailing Address - Fax:931-424-0368
Practice Address - Street 1:639 E MADISON ST
Practice Address - Street 2:
Practice Address - City:PULASKI
Practice Address - State:TN
Practice Address - Zip Code:38478-3521
Practice Address - Country:US
Practice Address - Phone:931-363-8504
Practice Address - Fax:931-424-0368
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-04
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL145052Medicaid
TN3523786Medicaid
TN704204700OtherDOL