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Organization

MED-CORP EMS, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MELISSA S HASSELL (PRESIDENT)
(770) 938-1166
Entity
Organization

Contact information

Practice address
2208 HANFORD LANE, STE 104, TUCKER, GA 30084
(770) 938-1166
Mailing address
2208 HANFORD LANE, STE 104, TUCKER, GA 30084
(770) 938-1166

Taxonomy

Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
044-25
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
59RCBPN
MEDICARE PTAN
GA
Enumeration date
04/17/2007
Last updated
06/16/2008
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