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Organization

WAYNE COUNTY AMBULANCE SERVICE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. RICHARD BLAKE JOHNSON (DIRECTOR)
(912) 427-5999
Entity
Organization

Contact information

Practice address
477 W BAY ST, JESUP, GA 31545-1223
(912) 427-5999
(912) 427-5906
Mailing address
PO BOX 270, JESUP, GA 31598-0270
(912) 427-5999
(912) 427-5906

Taxonomy

Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
151-01
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000348444A
GA
01
590008778
RAILROAD MEDICARE
GA
Enumeration date
12/13/2006
Last updated
01/22/2013
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