Organization
IRWIN COUNTY EMS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY W EDWARDS (DIRECTOR)
(229) 468-9594
Entity
Organization
Contact information
Practice address
108 COTTON DRIVE, OCILLA, GA 31774-0501
(229) 468-9594
(229) 468-9673
Mailing address
PO BOX 501, OCILLA, GA 31774-0501
(229) 468-9594
(229) 468-9673
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
077-01
GA
3416L0300X
Land Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000153205A
—
GA
01
—
198047
BCBS OF GA
GA
01
—
590014503
RAILROAD MEDICARE
GA
Enumeration date
02/13/2007
Last updated
02/05/2013
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