Provider Demographics
NPI:1821274200
Name:SCREVEN COUNTY COMMISSIONERS OF ROADS & REVENUE
Entity Type:Organization
Organization Name:SCREVEN COUNTY COMMISSIONERS OF ROADS & REVENUE
Other - Org Name:SCREVEN COUNTY EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMIN CLERK
Authorized Official - Prefix:MRS
Authorized Official - First Name:WANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-564-7535
Mailing Address - Street 1:PO BOX 159
Mailing Address - Street 2:
Mailing Address - City:SYLVANIA
Mailing Address - State:GA
Mailing Address - Zip Code:30467-0159
Mailing Address - Country:US
Mailing Address - Phone:912-564-7535
Mailing Address - Fax:912-564-2562
Practice Address - Street 1:618 FRONTAGE RD W
Practice Address - Street 2:
Practice Address - City:SYLVANIA
Practice Address - State:GA
Practice Address - Zip Code:30467-4888
Practice Address - Country:US
Practice Address - Phone:912-564-7535
Practice Address - Fax:912-564-2562
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-15
Last Update Date:2008-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA124-013416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport