Office of Gilmer County Commissioners

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

061-01 Issued in GA

Legal business name

OFFICE OF GILMER COUNTY COMMISSIONERS

Doing business as

Gilmer County Ambulance Service

Practice address

325 Howard Simmons Rd
Ellijay, GA 30540-6449

Phone

(706) 635-1333

Fax

(706) 635-1334

NPI assigned

Oct 28, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Sandra T Holden

Title

Financial Officer

Phone

(706) 635-4361

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Gilmer County Ambulance Service Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Tax ID family

Office of Gilmer Cty Comm2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Gilmer County Ambulance Service

  • Land Ambulance
  • Ellijay, GA
  • NPI 1952502338
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1130457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361923200000",
    "number": "1184614208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 HOWARD SIMMONS RD",
            "city": "ELLIJAY",
            "state": "GA",
            "postal_code": "305406449",
            "telephone_number": "706-635-1333",
            "fax_number": "706-635-1334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 HOWARD SIMMONS RD",
            "city": "ELLIJAY",
            "state": "GA",
            "postal_code": "305406449",
            "telephone_number": "706-635-1333",
            "fax_number": "706-635-1334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OFFICE OF GILMER COUNTY COMMISSIONERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-28",
        "last_updated": "2013-02-27",
        "status": "A",
        "authorized_official_last_name": "HOLDEN",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "FINANCIAL OFFICER",
        "authorized_official_telephone_number": "706-635-4361"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "GA",
            "license": "061-01",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000002692A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gilmer County Ambulance Service",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Echezona Anselm Okoli, PHARMD
• Alexis N. Pagan, DMD
• Claro Tesoro Palma, MD
• Donna Gale Palmer, LICENSED PROFESSIONA
• Parkside Operating Company LLC

• Land Ambulance in Ellijay, GA
• Providers in Ellijay, GA by specialty
• Land Ambulance in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.