Provider Demographics
NPI:1699778530
Name:WARREN COUNTY BOARD OF COMMISSIONERS
Entity type:Organization
Organization Name:WARREN COUNTY BOARD OF COMMISSIONERS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN, WARREN COUNTY COMMISSIONE
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:REESE
Authorized Official - Last Name:GRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:CHAIRMAN, EMT-P
Authorized Official - Phone:706-465-2171
Mailing Address - Street 1:PO BOX 46
Mailing Address - Street 2:521 MAIN ST
Mailing Address - City:WARRENTON
Mailing Address - State:GA
Mailing Address - Zip Code:30828-0046
Mailing Address - Country:US
Mailing Address - Phone:706-465-2221
Mailing Address - Fax:706-465-1300
Practice Address - Street 1:169 HWY 80
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:GA
Practice Address - Zip Code:30828-8851
Practice Address - Country:US
Practice Address - Phone:706-465-3358
Practice Address - Fax:706-465-1300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-24
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA149-013416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA58-60000904OtherEIN
GA00003132AMedicaid
GA85032759AAMedicare PIN