Organization
SOUTHERN EMS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN BALLESTEROS PARAMEDIC (DIRECTOR)
(404) 768-1223
Entity
Organization
Contact information
Practice address
1395 SOUTHLAKE PKWY, SUITE D, MORROW, GA 30260-2337
(404) 768-1223
Mailing address
PO BOX 82451, HAPEVILLE, GA 30354-0451
(404) 768-1223
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
060-34
GA
Other
Enumeration date
01/27/2007
Last updated
08/22/2020
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