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Organization
DEEP SOUTH AMBULANCE SERVICE, INC
Active
Organization
DEEP SOUTH AMBULANCE SERVICE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN WESLEY PRUITT SR. (OWNER)
(229) 482-2899
Entity
Organization
Contact information
Practice address
37 PEACHTREE STREET, LAKELAND, GA 31635-0067
(229) 482-2899
Mailing address
PO BOX 67, 37 PEACHTREE ST, LAKELAND, GA 31635-0067
(229) 482-2899
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
086-02
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00432528A
—
GA
Enumeration date
01/10/2007
Last updated
01/15/2013
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