Provider Demographics
NPI:1942386289
Name:BUTTS COUNTY BOARD OF COMMISSIONERS
Entity Type:Organization
Organization Name:BUTTS COUNTY BOARD OF COMMISSIONERS
Other - Org Name:BUTTS COUNTY FIRE DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EMS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:WESLEY
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:JOHNSTON
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:770-715-1729
Mailing Address - Street 1:625 W 3RD ST
Mailing Address - Street 2:SUITE 14
Mailing Address - City:JACKSON
Mailing Address - State:GA
Mailing Address - Zip Code:30233-1881
Mailing Address - Country:US
Mailing Address - Phone:770-775-8200
Mailing Address - Fax:770-775-8211
Practice Address - Street 1:1372 HIGHWAY 42 S
Practice Address - Street 2:
Practice Address - City:FLOVILLA
Practice Address - State:GA
Practice Address - Zip Code:30216-2124
Practice Address - Country:US
Practice Address - Phone:678-774-8154
Practice Address - Fax:770-775-8211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-30
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003253579AMedicaid
GA85043959AAMedicare PIN