Provider Demographics
NPI:1730133471
Name:COLUMBUS CONSOLIDATED GOVERNMENT
Entity type:Organization
Organization Name:COLUMBUS CONSOLIDATED GOVERNMENT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COLLECTION SUPERVISOR
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWIN
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-225-3090
Mailing Address - Street 1:PO BOX 1397
Mailing Address - Street 2:100 10TH ST
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31902-1397
Mailing Address - Country:US
Mailing Address - Phone:706-653-4100
Mailing Address - Fax:706-653-4545
Practice Address - Street 1:3111 CITIZENS WAY
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31906-2681
Practice Address - Country:US
Practice Address - Phone:706-653-4100
Practice Address - Fax:706-225-3777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2015-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA10601146L00000X, 146M00000X
GA10610146N00000X
341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes341600000XTransportation ServicesAmbulanceGroup - Multi-Specialty
No146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, ParamedicGroup - Multi-Specialty
No146M00000XEmergency Medical Service ProvidersEmergency Medical Technician, IntermediateGroup - Multi-Specialty
No146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, BasicGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000002945AMedicaid
GA000002945AMedicaid