=====================================================
General NPI Number Information
=====================================================
NPI Number | 1265808778
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PRECISION EMERGENCY MEDICAL SERVICES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/19/2015
-----------------------------------------------------
Last Update Date | 02/25/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 180 SHAMROCK INDUSTRIAL BLVD STE A
-----------------------------------------------------
City | TYRONE
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30290-2719
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 770-318-9933
-----------------------------------------------------
Fax | 770-954-1757
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 1536
-----------------------------------------------------
City | MCDONOUGH
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30253-1536
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 770-318-9933
-----------------------------------------------------
Fax | 770-954-1757
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | ROB LUNSFORD
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 770-318-9933
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 341600000X
-----------------------------------------------------
Taxonomy Name | Ambulance
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------