# UNITED MEDICAL RESPONSE LLC

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

## Provider details

- **NPI number:** 1982836581
- **Authorized official:** MR. CHARLES DERRICK ISHAM (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (770) 866-2120

## Contact information

- **Practice address:** 2425 JASON INDUSTRIAL PKWY, WINSTON, GA 30187
- **Practice address phone:** (770) 672-6434
- **Practice address fax:** (205) 993-4090
- **Mailing address:** 515 E CROSSVILLE RD, SUITE 170, ROSWELL, GA 30075-3087
- **Mailing address phone:** (770) 299-1516
- **Mailing address fax:** (770) 299-1518

## Taxonomy

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

## Other

- **Enumeration date:** 08/14/2009
- **Last updated:** 07/12/2018