Organization
SOUTHLAND EMERGENCY MEDICAL SERVICES CONSOLIDATED, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE FLETCHER (CFO)
(292) 236-0831
Entity
Organization
Contact information
Practice address
145 E PEACOCK ST, COCHRAN, GA 31014-7846
(478) 934-6211
Mailing address
PO BOX 102545, ATLANTA, GA 30368-2545
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
208M00000X
Hospitalist Physician
Primary
—
—
Other
Enumeration date
07/23/2012
Last updated
05/28/2019
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