Commissioner of Roads and Revenue Dawson County
Organization Active NPI Land Ambulance · Dawsonville, GA
NPI 1023063567 · NPPES record last updated Feb 6, 2013
Key facts
- NPI
- 1023063567
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Land Ambulance 3416L0300X
- Legal business name
- COMMISSIONER OF ROADS AND REVENUE DAWSON COUNTY
- Practice address
- 393 Memory LN
Dawsonville, GA 30534-4315 - Phone
- (706) 344-3501
- Fax
- (706) 344-3504
- NPI assigned
- May 23, 2006
- Organization subpart
- No
Authorized official
- Name
- Mrs. Cynthia Denise Campbell
- Title
- County Manager
- Phone
- (706) 344-3501
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 11D2199326 | Dawson County Fire & Emergency Services | Certificate of waiver | Nov 5, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20041102000144 | GA | Part B Supplier - Ambulance Service Supplier | 8729040795 | Practice locations: Dawsonville, GA |
National Provider Directory
Locations
25 Justice Way
Ste 2000
Dawsonville, GA 30534
393 Memory Ln
Dawsonville, GA 30534
Phone (706) 344-3501
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | 042-01 | GA | |
| Land Ambulance | 3416L0300X | Yes |
Addresses
Primary practice location
393 Memory LN
Dawsonville, GA 30534-4315
Mailing address
393 Memory LN
Dawsonville, GA 30534-4315
Phone (706) 344-3501
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000313893A | Medicaid | GA | |
| 85011759AA | Other | MEDICARE PROVIDER ID # |
Other names
- Dawson County Emergency Services
Other providers in Dawsonville, GA
- Alexander Stuart Christ
- Roman M Cibirka
- Mariya Cissell
- Jodi Cofer
- Kelly Lynn Combs
- Comprehensive Internal Medicine at Dawsonville, LLC
- Connell and Kim, O.D. Associates Limited Liability Company
- Cymanthia Keesha Connell
- Darlene Cooper
- Jennifer Cooper
All providers in Dawsonville, GA · Land Ambulance in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 6, 2013. 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.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.