Provider Demographics
NPI:1881780799
Name:HARRIS COUNTY COMMISSIONER OF ROADS & REVENUES
Entity type:Organization
Organization Name:HARRIS COUNTY COMMISSIONER OF ROADS & REVENUES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-628-4284
Mailing Address - Street 1:PO BOX 365
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:GA
Mailing Address - Zip Code:31811-0365
Mailing Address - Country:US
Mailing Address - Phone:706-628-4284
Mailing Address - Fax:
Practice Address - Street 1:9907 HWY 116
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:GA
Practice Address - Zip Code:31811
Practice Address - Country:US
Practice Address - Phone:706-628-4284
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2013-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA072-023416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00182476AMedicaid
GA00182476AMedicaid