Organization
BULLOCH COUNTY EMERGENCY MEDICAL SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOUGLAS C VICKERS (INTERIM DIRECTOR)
(912) 764-6188
Entity
Organization
Contact information
Practice address
26 W GRADY ST, STATESBORO, GA 30458-2742
(912) 764-6188
(912) 489-8917
Mailing address
PO BOX 1409, STATESBORO, GA 30459-1409
(912) 764-6188
(912) 489-8917
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
01602
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00263227A
—
GA
Enumeration date
08/25/2006
Last updated
01/09/2013
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