# IRWIN COUNTY EMS

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

## Provider details

- **NPI number:** 1831231216
- **Authorized official:** JERRY W EDWARDS (DIRECTOR)
- **Authorized official phone:** (229) 468-9594

## Contact information

- **Practice address:** 108 COTTON DRIVE, OCILLA, GA 31774-0501
- **Practice address phone:** (229) 468-9594
- **Practice address fax:** (229) 468-9673
- **Mailing address:** PO BOX 501, OCILLA, GA 31774-0501
- **Mailing address phone:** (229) 468-9594
- **Mailing address fax:** (229) 468-9673

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 077-01 | GA | — |
| 3416L0300X | Land Ambulance | — | NULL | Yes |

## Other

- **Enumeration date:** 02/13/2007
- **Last updated:** 02/05/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 000153205A | — | GA |
| 01 | — | 198047 | BCBS OF GA | GA |
| 01 | — | 590014503 | RAILROAD MEDICARE | GA |