Provider Demographics
NPI:1952162273
Name:COUNTY OF WYTHE BOARD OF SUPERVISORS
Entity Type:Organization
Organization Name:COUNTY OF WYTHE BOARD OF SUPERVISORS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMERGENCY SERVICES CONSULTANT
Authorized Official - Prefix:MR
Authorized Official - First Name:CODY
Authorized Official - Middle Name:G
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:276-620-8916
Mailing Address - Street 1:340 S 6TH ST
Mailing Address - Street 2:
Mailing Address - City:WYTHEVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24382-2513
Mailing Address - Country:US
Mailing Address - Phone:276-620-8916
Mailing Address - Fax:
Practice Address - Street 1:340 S 6TH ST
Practice Address - Street 2:
Practice Address - City:WYTHEVILLE
Practice Address - State:VA
Practice Address - Zip Code:24382-2513
Practice Address - Country:US
Practice Address - Phone:276-620-8916
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-23
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport