Healthcare Provider Details

I. General information

NPI: 1609859818
Provider Name (Legal Business Name): JASPER COUNTY EMERGENCY MEDICAL SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2005
Last Update Date: 06/17/2022
Certification Date: 06/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

185 HIGHWAY 212 W
MONTICELLO GA
31064-0000
US

IV. Provider business mailing address

126 W. GREENE ST. SUITE 031
MONTICELLO GA
31064-1171
US

V. Phone/Fax

Practice location:
  • Phone: 706-468-4943
  • Fax: 706-468-4939
Mailing address:
  • Phone: 706-468-1091
  • Fax: 706-468-5010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number079-02
License Number StateGA

VIII. Authorized Official

Name: CHRISTOPHER FINCH
Title or Position: EMS DIRECTOR
Credential:
Phone: 678-603-8915