# AMBULANCE SERVICE MANAGEMENT, LLC

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

## Provider details

- **NPI number:** 1972802601
- **Authorized official:** MR. LEONARD HOWELL COLEMAN III (CFO)
- **Authorized official phone:** (678) 343-2020

## Contact information

- **Practice address:** 2305 DANBURY LN, SUITE C, GAINESVILLE, GA 30507-7311
- **Practice address phone:** (678) 343-2020
- **Mailing address:** 2305 DANBURY LN, SUITE C, GAINESVILLE, GA 30507-7311
- **Mailing address phone:** (678) 343-2020

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 069-23 | GA | Yes |

## Other

- **Enumeration date:** 03/21/2011
- **Last updated:** 12/11/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 003129426A | — | GA |
| 01 | — | 202G595426 | MEDICARE PTAN | GA |