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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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