Organization
HEART OF GEORGIA MEDICAL TRANSPORT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN WILSON EMT-I (REGISTERED AGENT)
(478) 335-1817
Entity
Organization
Contact information
Practice address
2014 RIVERSIDE DR., SUITE 2F, MACON, GA 31204-2055
(478) 960-1067
Mailing address
PO BOX 5623, MACON, GA 31208-5623
(478) 960-1067
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
011-05
GA
Other
Enumeration date
01/16/2013
Last updated
02/21/2013
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