Organization
BRAVEHEART MEDICAL RESPONSE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BERNADETTE MOORE (PRESIDENT)
(770) 802-4700
Entity
Organization
Contact information
Practice address
650 HILLCREST RD NW, SUITE 100, LILBURN, GA 30047-1711
(770) 802-4700
(770) 802-4702
Mailing address
528 FOREST PKWY STE E, FOREST PARK, GA 30297-6109
(404) 366-5298
(404) 366-5299
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
AMB2017007
GA
Other
Enumeration date
03/27/2017
Last updated
10/28/2019
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