Provider Demographics
NPI:1952319360
Name:BRYAN COUNTY BOARD OF COMMISSIONERS
Entity Type:Organization
Organization Name:BRYAN COUNTY BOARD OF COMMISSIONERS
Other - Org Name:BRYAN COUNTY EMERGENCY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:FREDDY
Authorized Official - Middle Name:
Authorized Official - Last Name:HOWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-858-2799
Mailing Address - Street 1:PO BOX 430
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE
Mailing Address - State:GA
Mailing Address - Zip Code:31321-0430
Mailing Address - Country:US
Mailing Address - Phone:912-858-2799
Mailing Address - Fax:912-441-0426
Practice Address - Street 1:15759 HWY 144
Practice Address - Street 2:
Practice Address - City:RICHMOND HILL
Practice Address - State:GA
Practice Address - Zip Code:31324
Practice Address - Country:US
Practice Address - Phone:912-858-2799
Practice Address - Fax:912-441-0426
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-03
Last Update Date:2022-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA015-013416L0300X, 3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003205235AMedicaid
GA00002604AMedicaid
GA00002604AMedicaid