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General NPI Number Information
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NPI Number | 1316443153
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Entity Type | Organization
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Legal Business Name | MALTESE MEDICAL RESPONSE
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Dates
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Enumeration Date | 04/02/2018
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Last Update Date | 04/02/2018
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Provider Practice Location Address
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Address Line | 4406 CENTRAL CHURCH RD
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City | DOUGLASVILLE
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State | GA
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Zip | 30135-2762
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Country | US
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Telephone | 404-354-2874
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Fax |
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Provider Business Mailing Address
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Address Line | 4406 CENTRAL CHURCH RD
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City | DOUGLASVILLE
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State | GA
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Zip | 30135-2762
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Country | US
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Telephone | 404-354-2874
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | CHRISTOPHER PAUL PARKER
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Credential |
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Telephone | 404-354-2874
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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 | GA
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