Organization
EMERGENCY MEDICAL SERVICE OF RANDOLPH COUNTY GA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ELLETTE JACKSON PARAMEDIC (EMS DIRECTOR)
(229) 732-6632
Entity
Organization
Contact information
Practice address
34 TAYLOR STREET, CUTHBERT, GA 39840-1338
(229) 732-6632
(229) 732-2139
Mailing address
361 RANDOLPH STREET, CUTHBERT, GA 39840-1338
(229) 732-6632
(229) 732-2139
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
12001
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000002593A
—
GA
Enumeration date
05/13/2006
Last updated
11/29/2010
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