# GILMER COUNTY AMBULANCE SERVICE

> 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:** 1952502338
- **Authorized official:** TRAVIS WORTHINGTON (DIRECTOR)
- **Authorized official phone:** (706) 635-1333

## Contact information

- **Practice address:** 1 W SIDE SQ, ELLIJAY, GA 30540-3326
- **Practice address phone:** (706) 635-1333
- **Mailing address:** 1 W SIDE SQ, ELLIJAY, GA 30540-3326
- **Mailing address phone:** (706) 635-1333

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 061-01 | GA | Yes |

## Other

- **Enumeration date:** 05/31/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00002692A | — | GA |
| 01 | — | 52191385 | BCBS OF GA | GA |