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Organization
GLYNN COUNTY GEORGIA
Active
Organization
GLYNN COUNTY GEORGIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERESA RENEE SHORB (ADMINISTRATIVE SUPERVISOR)
(912) 554-7779
Entity
Organization
Contact information
Practice address
121 PUBLIC SAFETY BLVD, BRUNSWICK, GA 31525-8906
(912) 554-7779
(912) 297-3695
Mailing address
PO BOX 429, LEWISVILLE, NC 27023-0429
(877) 200-1191
(336) 740-9793
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
063-01
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000002703A
—
GA
01
—
590003739
MEDICARE RAILROAD
GA
Enumeration date
10/27/2005
Last updated
04/28/2026
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