Provider Demographics
NPI:1821220385
Name:UNIFIED GOVERNMENT OF GEORGETOWN-QUITMAN COUNTY GEORGIA
Entity Type:Organization
Organization Name:UNIFIED GOVERNMENT OF GEORGETOWN-QUITMAN COUNTY GEORGIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNTY COMMISSIONER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-334-0903
Mailing Address - Street 1:PO BOX 9026
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30065-2026
Mailing Address - Country:US
Mailing Address - Phone:229-334-0903
Mailing Address - Fax:229-334-2151
Practice Address - Street 1:845 HWY 82
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:GA
Practice Address - Zip Code:39854
Practice Address - Country:US
Practice Address - Phone:229-334-0903
Practice Address - Fax:229-334-2151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-18
Last Update Date:2013-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA118-01341600000X
GA118-03341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance