# BRANTLEY COUNTY EMS

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

## Provider details

- **NPI number:** 1013041615
- **Authorized official:** GARY W RIGGAN (DIRECTOR)
- **Authorized official phone:** (912) 462-5380

## Contact information

- **Practice address:** 1366 BROOME STREET, NAHUNTA, GA 31553
- **Practice address phone:** (912) 462-5380
- **Practice address fax:** (912) 462-5309
- **Mailing address:** PO BOX 798, NAHUNTA, GA 31553-0798
- **Mailing address phone:** (912) 462-5380
- **Mailing address fax:** (912) 462-5309

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 01301 | GA | Yes |

## Other

- **Enumeration date:** 03/15/2007
- **Last updated:** 08/25/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00180342A | — | GA |