Organization
HOSPITAL AMBULANCE OF GEORGIA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAY NETTLES (OWNER)
(843) 229-1617
Entity
Organization
Contact information
Practice address
181B SW UPPER RIVERDALE RD, RIVERDALE, GA 30274-0000
(843) 229-1617
(770) 490-0038
Mailing address
PO BOX 1117, FAYETTEVILLE, GA 30214-6117
(770) 719-5337
(770) 907-1588
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
031-21
GA
Other
Enumeration date
08/18/2008
Last updated
08/18/2008
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