# SOUTHERN REGIONAL EMS LLC

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

## Provider details

- **NPI number:** 1518732643
- **Authorized official:** GRANT P BARKER (PRESIDENT)
- **Authorized official phone:** (229) 358-0001

## Contact information

- **Practice address:** 215 S CULPEPPER ST, QUITMAN, GA 31643-2707
- **Practice address phone:** (727) 515-3119
- **Mailing address:** 1640 ABERDEEN ST, JACKSONVILLE, FL 32205-8636
- **Mailing address phone:** (727) 515-3119

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 341600000X | Ambulance | — | NULL | Yes |

## Other

- **Enumeration date:** 11/20/2023
- **Last updated:** 10/22/2024