McIntosh County Commissioners of Roads & Revenue
Organization Active NPI Ambulance · Darien, GA
NPI 1841200441 · NPPES record last updated Aug 15, 2024
Key facts
- NPI
- 1841200441
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Ambulance 341600000X
- License
- 098-03 (GA)
- Legal business name
- MCINTOSH COUNTY COMMISSIONERS OF ROADS & REVENUE
- Practice address
- 1019 Production Row SW
Darien, GA 31305-6151 - Phone
- (912) 832-6265
- Fax
- (952) 985-5671
- NPI assigned
- Aug 8, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Franklin Wallace
- Title
- Director
- Phone
- (912) 437-6671
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040914000542 | GA | Part B Supplier - Ambulance Service Supplier | 9638146194 | Practice locations: Darien, GA |
National Provider Directory
Locations
1019 Production Row SW
Darien, GA 31305
Phone (912) 437-4355
103 Jefferson St
Darien, GA 31305
Phone (912) 437-4561
1040 Barfield Rd SW
Townsend, GA 31331
Phone (912) 832-6265
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulance | 341600000X | 098-03 | GA | Yes |
Addresses
Primary practice location
1019 Production Row SW
Darien, GA 31305-6151
Mailing address
PO Box 429
Lewisville, NC 27023-0429
Phone (877) 200-1191
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00327225A | Medicaid | GA |
Other names
- McIntosh County EMS
Other providers in Darien, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 15, 2024. 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.