# GLYNN COUNTY GEORGIA

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1851381156
- **Authorized official:** TERESA RENEE SHORB (ADMINISTRATIVE SUPERVISOR)
- **Authorized official phone:** (912) 554-7779

## Contact information

- **Practice address:** 121 PUBLIC SAFETY BLVD, BRUNSWICK, GA 31525-8906
- **Practice address phone:** (912) 554-7779
- **Practice address fax:** (912) 297-3695
- **Mailing address:** PO BOX 429, LEWISVILLE, NC 27023-0429
- **Mailing address phone:** (877) 200-1191
- **Mailing address fax:** (336) 740-9793

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 063-01 | GA | Yes |

## Other

- **Enumeration date:** 10/27/2005
- **Last updated:** 04/28/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 000002703A | — | GA |
| 01 | — | 590003739 | MEDICARE RAILROAD | GA |