Provider Demographics
NPI:1831260306
Name:HANCOCK COUNTY COMMISSIONER OF ROADS & REVENUES
Entity type:Organization
Organization Name:HANCOCK COUNTY COMMISSIONER OF ROADS & REVENUES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:THEODORE
Authorized Official - Middle Name:
Authorized Official - Last Name:PATTERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-998-0585
Mailing Address - Street 1:12630 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:GA
Mailing Address - Zip Code:31087-1731
Mailing Address - Country:US
Mailing Address - Phone:706-444-7575
Mailing Address - Fax:706-444-6221
Practice Address - Street 1:52 SPRING ST
Practice Address - Street 2:
Practice Address - City:SPARTA
Practice Address - State:GA
Practice Address - Zip Code:31087-1703
Practice Address - Country:US
Practice Address - Phone:706-444-7575
Practice Address - Fax:706-444-6221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA59RCBLHMedicare ID - Type Unspecified