Provider Demographics
NPI:1588703003
Name:DEKALB COUNTY BOARD OF COMMISSIONERS
Entity type:Organization
Organization Name:DEKALB COUNTY BOARD OF COMMISSIONERS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:DARNELL
Authorized Official - Middle Name:
Authorized Official - Last Name:FULLUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-406-7750
Mailing Address - Street 1:PO BOX 102371
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30368-2371
Mailing Address - Country:US
Mailing Address - Phone:800-782-9176
Mailing Address - Fax:
Practice Address - Street 1:1950 W EXCHANGE PL
Practice Address - Street 2:5TH FLOOR
Practice Address - City:TUCKER
Practice Address - State:GA
Practice Address - Zip Code:30084-5329
Practice Address - Country:US
Practice Address - Phone:678-406-7793
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2021-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA044-02341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA85028859AAMedicare ID - Type UnspecifiedCURRENT MEDICARE NUMBER