County of Hamilton
Organization Active NPI Land Ambulance · Jasper, FL
NPI 1003851767 · NPPES record last updated May 10, 2012
Key facts
- NPI
- 1003851767
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Land Ambulance 3416L0300X
- License
- 002519 (FL)
- Legal business name
- COUNTY OF HAMILTON
- Practice address
- 207 1St St NE
902 US Hwy 41 NW
Jasper, FL 32052-6633 - Phone
- (386) 792-1288
- Fax
- (386) 792-6432
- NPI assigned
- Jun 18, 2006
- Organization subpart
- No
Authorized official
- Name
- Ms. Lisa L. Harris
- Title
- Accounts Manager
- Phone
- (386) 792-6817
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120511000264 | FL | Part B Supplier - Ambulance Service Supplier | 6103089008 | Practice locations: Jasper, FL |
National Provider Directory
Locations
902 US Highway 41 NW
Jasper, FL 32052
Phone (386) 792-1288
207 1st St NE
Rm 6
Jasper, FL 32052
207 1st St NE
Jasper, FL 32052
306 8th Ave NW
Jasper, FL 32052
Phone (386) 792-6447
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | 002519 | FL | Yes |
Addresses
Primary practice location
207 1St St NE
902 US Hwy 41 NW
Jasper, FL 32052-6633
Mailing address
207 1St St NE
Jasper, FL 32052-6633
Phone (386) 792-1288
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 088053100 | Medicaid | FL |
NPI Registry JSON
{
"created_epoch": "1150588800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1336608000000",
"number": "1003851767",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "207 1ST ST NE",
"city": "JASPER",
"state": "FL",
"postal_code": "320526633",
"telephone_number": "386-792-1288",
"fax_number": "386-792-6432"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "207 1ST ST NE",
"address_2": "902 US HWY 41 NW",
"city": "JASPER",
"state": "FL",
"postal_code": "320526633",
"telephone_number": "386-792-1288",
"fax_number": "386-792-6432"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "COUNTY OF HAMILTON",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-18",
"last_updated": "2012-05-10",
"status": "A",
"authorized_official_last_name": "HARRIS",
"authorized_official_first_name": "LISA",
"authorized_official_middle_name": "L.",
"authorized_official_title_or_position": "ACCOUNTS MANAGER",
"authorized_official_telephone_number": "386-792-6817",
"authorized_official_name_prefix": "Ms."
},
"taxonomies": [
{
"code": "3416L0300X",
"taxonomy_group": "",
"desc": "Ambulance, Land Transport",
"state": "FL",
"license": "002519",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "088053100",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Jasper, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 10, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.