Healthcare Provider Details

I. General information

NPI: 1356780266
Provider Name (Legal Business Name): MED CARE EMS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2013
Last Update Date: 02/01/2025
Certification Date: 02/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4560 FRONTIER PARK CIR
SUGAR HILL GA
30518-5373
US

IV. Provider business mailing address

4560 FRONTIER PARK CIR
SUGAR HILL GA
30518-5373
US

V. Phone/Fax

Practice location:
  • Phone: 770-710-1373
  • Fax: 678-765-6393
Mailing address:
  • Phone: 770-710-1373
  • Fax: 678-765-6393

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number06928
License Number StateGA

VIII. Authorized Official

Name: AL-HASSAN ALIYU
Title or Position: CHIEF EXECUTIVE
Credential:
Phone: 770-710-1373