Provider Demographics
NPI:1194762450
Name:BOARD OF COUNTY COMMISSIONERS IN LEE COUNTY GEORGIA
Entity type:Organization
Organization Name:BOARD OF COUNTY COMMISSIONERS IN LEE COUNTY GEORGIA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FINANCE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-759-6000
Mailing Address - Street 1:102 STARKSVILLE AVE N
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:GA
Mailing Address - Zip Code:31763-4548
Mailing Address - Country:US
Mailing Address - Phone:229-759-6000
Mailing Address - Fax:229-435-5436
Practice Address - Street 1:342 LESLIE HWY
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:GA
Practice Address - Zip Code:31763-4385
Practice Address - Country:US
Practice Address - Phone:229-759-6011
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LEE COUNTY BOARD OF COMMISSIONERS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-02
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA088-01341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000068208AMedicaid
GA85036159AAMedicare ID - Type Unspecified