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Organization
EMERGENCY MEDICAL SERVICE OF RANDOLPH COUNTY GA
Active
Organization
EMERGENCY MEDICAL SERVICE OF RANDOLPH COUNTY GA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ELLETTE JACKSON PARAMEDIC (EMS DIRECTOR)
(229) 732-6632
Entity
Organization
Contact information
Practice address
34 TAYLOR STREET, CUTHBERT, GA 39840-1338
(229) 732-6632
(229) 732-2139
Mailing address
361 RANDOLPH STREET, CUTHBERT, GA 39840-1338
(229) 732-6632
(229) 732-2139
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
12001
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000002593A
—
GA
Enumeration date
05/13/2006
Last updated
11/29/2010
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