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General NPI Number Information
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NPI Number | 1225479744
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Entity Type | Organization
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Legal Business Name | PHOENIX EMERGENCY MEDICAL SERVICES LLC
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Dates
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Enumeration Date | 07/12/2013
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Last Update Date | 10/27/2022
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Provider Practice Location Address
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Address Line | 1518 OLD HWY 3 N
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City | HAMPTON
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State | GA
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Zip | 30228
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Country | US
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Telephone | 770-914-5512
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Fax | 770-981-9078
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Provider Business Mailing Address
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Address Line | PO BOX 1536
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City | MCDONOUGH
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State | GA
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Zip | 30253-1536
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Country | US
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Telephone | 770-914-5512
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Fax | 770-981-9078
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | MR. ROB WESLEY LUNSFORD
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Credential |
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Telephone | 770-914-5512
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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 | 075-12
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License Number State | GA
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