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General NPI Number Information
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NPI Number | 1184412553
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Entity Type | Organization
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Legal Business Name | PIONEER AMBULANCE SERVICES LLC
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Dates
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Enumeration Date | 04/28/2025
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Last Update Date | 04/28/2025
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Provider Practice Location Address
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Address Line | 900 N HAIRSTON RD STE C
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City | STONE MOUNTAIN
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State | GA
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Zip | 30083-2857
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Country | US
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Telephone | 404-425-6387
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Fax |
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Provider Business Mailing Address
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Address Line | 900 N HAIRSTON RD STE C
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City | STONE MOUNTAIN
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State | GA
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Zip | 30083-2857
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED AGENT
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Name | MUMTAZ ROBOW
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Credential |
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Telephone | 404-425-6387
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number |
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License Number State |
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