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General NPI Number Information
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NPI Number | 1215920459
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Entity Type | Organization
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Legal Business Name | CAPITAL CITY AMBULANCE OF GEORGIA INC
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Dates
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Enumeration Date | 08/23/2005
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Last Update Date | 08/18/2017
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Provider Practice Location Address
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Address Line | 2623 WASHINGTON RD STE E101
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City | AUGUSTA
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State | GA
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Zip | 30904-5965
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Country | US
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Telephone | 706-829-7771
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Fax | 803-442-9024
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Provider Business Mailing Address
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Address Line | 2623 WASHINGTON ROAD E101
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City | AUGUSTA
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State | GA
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Zip | 30904
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Country | US
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Telephone | 706-829-7771
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Fax | 803-442-9024
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Authorized Official
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Title or Position | CEO
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Name | THOMAS F ADKINS
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Credential |
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Telephone | 706-829-7771
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number | 62191
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License Number State | GA
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