Organization
WEST GEORGIA STAR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOCIES EDMONDSON (TRANSPORTATION AGENT)
(706) 616-3545
Entity
Organization
Contact information
Practice address
201 CHATHAM ST, LAGRANGE, GA 30240-5313
(706) 616-3545
Mailing address
201 CHATHAM ST, LAGRANGE, GA 30240-5313
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
05/24/2017
Last updated
05/24/2017
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