Provider Demographics
NPI:1992734867
Name:HALL COUNTY GEORGIA
Entity type:Organization
Organization Name:HALL COUNTY GEORGIA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIVISION CHIEF OF EMS
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GRICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-531-6838
Mailing Address - Street 1:PO BOX 931136
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:31193-1136
Mailing Address - Country:US
Mailing Address - Phone:770-531-6838
Mailing Address - Fax:770-531-6845
Practice Address - Street 1:470 CRESCENT DR
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-5079
Practice Address - Country:US
Practice Address - Phone:770-531-6835
Practice Address - Fax:770-531-6845
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-02
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA069073416L0300X, 341800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341800000XTransportation ServicesMilitary/U.S. Coast Guard Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00236992AMedicaid
GA85047259AAMedicare ID - Type Unspecified