# COLQUITT REGIONAL MEDICAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** COLQUITT REGIONAL MEDICAL CENTER
- **Other names:** Colquitt County EMS
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1720593239
- **Legal business name:** COLQUITT REGIONAL MEDICAL CENTER
- **Authorized official:** GREG JOHNSON (COO)
- **Authorized official phone:** (229) 985-3420

## Contact information

- **Practice address:** 3131 S MAIN ST, MOULTRIE, GA 31768-6925
- **Practice address phone:** (229) 891-9277
- **Practice address fax:** (229) 502-9645
- **Mailing address:** PO BOX 2172, MOULTRIE, GA 31776-2172
- **Mailing address phone:** (229) 891-9277
- **Mailing address fax:** (229) 502-9645

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | — | NULL | Yes |

## Other

- **Enumeration date:** 12/06/2017
- **Last updated:** 12/06/2017