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Organization
AMBULANCE SERVICE MANAGEMENT, LLC
Active
Organization
AMBULANCE SERVICE MANAGEMENT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LEONARD HOWELL COLEMAN III (CFO)
(678) 343-2020
Entity
Organization
Contact information
Practice address
2305 DANBURY LN, SUITE C, GAINESVILLE, GA 30507-7311
(678) 343-2020
Mailing address
2305 DANBURY LN, SUITE C, GAINESVILLE, GA 30507-7311
(678) 343-2020
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
069-23
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003129426A
—
GA
01
—
202G595426
MEDICARE PTAN
GA
Enumeration date
03/21/2011
Last updated
12/11/2013
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