Healthcare Provider Details

I. General information

NPI: 1780493205
Provider Name (Legal Business Name): KJC UNLIMITED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/31/2024
Last Update Date: 12/31/2024
Certification Date: 12/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

67 LINGER LONGER DR
ELLIJAY GA
30540-6908
US

IV. Provider business mailing address

67 LINGER LONGER DR
ELLIJAY GA
30540-6908
US

V. Phone/Fax

Practice location:
  • Phone: 678-416-3920
  • Fax:
Mailing address:
  • Phone: 678-416-3920
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416A0800X
TaxonomyAir Ambulance
License Number
License Number State

VIII. Authorized Official

Name: MR. KYLE SCOTT COLE
Title or Position: OWNER
Credential:
Phone: 404-635-6329