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Organization
PREMIERE EMS, LLC.
Active
Organization
PREMIERE EMS, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES WESLEY SHURLING (CEO)
(770) 445-8177
Entity
Organization
Contact information
Practice address
620 W MEMORIAL DR, SUITE F, DALLAS, GA 30132-3440
(770) 445-8177
(770) 445-8160
Mailing address
PO BOX 1234, 620 WEST MEMORIAL DRIVE SUITE F, DALLAS, GA 30132-0021
(770) 445-8177
(770) 445-8160
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
110-08
GA
343900000X
Non-emergency Medical Transport (VAN)
11008
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
307141905A
—
GA
01
—
511G590002
MEDICARE PART B
GA
Enumeration date
08/20/2007
Last updated
01/22/2009
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