# SOUTHERN EMS, INC

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

## Provider details

- **NPI number:** 1285780577
- **Authorized official:** JONATHAN BALLESTEROS PARAMEDIC (DIRECTOR)
- **Authorized official phone:** (404) 768-1223

## Contact information

- **Practice address:** 1395 SOUTHLAKE PKWY, SUITE D, MORROW, GA 30260-2337
- **Practice address phone:** (404) 768-1223
- **Mailing address:** PO BOX 82451, HAPEVILLE, GA 30354-0451
- **Mailing address phone:** (404) 768-1223

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 060-34 | GA | Yes |

## Other

- **Enumeration date:** 01/27/2007
- **Last updated:** 08/22/2020