Healthcare Provider Details

I. General information

NPI: 1437953320
Provider Name (Legal Business Name): SWIFT EMERGENCY MEDICAL SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2025
Last Update Date: 04/01/2025
Certification Date: 04/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 KEITH RD
BONAIRE GA
31005-4112
US

IV. Provider business mailing address

102 KEITH RD
BONAIRE GA
31005-4112
US

V. Phone/Fax

Practice location:
  • Phone: 478-714-3612
  • Fax:
Mailing address:
  • Phone: 478-714-3612
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: JACOB C MCCULLOUGH
Title or Position: CEO/OWNER
Credential:
Phone: 478-714-3612