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Organization
DEPLOYED TACTICS
Active
Organization
DEPLOYED TACTICS
Active
Other names
Tactical 1st Response
Organization subpart
No
Provider details
NPI number
Authorized official
ASHTON BLAIR HOLMES EMT (CHIEF OF OPERATIONS)
(202) 655-8161
Entity
Organization
Contact information
Practice address
40 JUDY CT PH A, STOCKBRIDGE, GA 30281-3876
(202) 655-8161
Mailing address
40 JUDY CT # B, STOCKBRIDGE, GA 30281-3876
(202) 655-8161
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
—
—
261QC1500X
Community Health Clinic/Center
—
—
261QE0002X
Emergency Care Clinic/Center
Primary
—
—
261QP0904X
Federal Public Health Clinic/Center
—
—
261QP0905X
State or Local Public Health Clinic/Center
—
—
341600000X
Ambulance
—
—
3416L0300X
Land Ambulance
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
057070191
DL
GA
Enumeration date
06/16/2022
Last updated
06/16/2022
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