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Organization

LIFE STAT EMS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MICHAEL L WATERS (BILLING MANAGER)
(770) 490-3911
Entity
Organization

Contact information

Practice address
3551 BALL GROUND HWY, CANTON, GA 30114-7411
(404) 987-6278
(678) 807-2631
Mailing address
PO BOX 4636, CANTON, GA 30114-0019
(404) 987-6278
(678) 807-2631

Taxonomy

Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary

Other

Enumeration date
10/06/2021
Last updated
01/20/2022
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