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General NPI Number Information
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NPI Number | 1588974521
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Entity Type | Organization
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Legal Business Name | PIONEER HEALTH SERVICES OF EARLY COUNTY, LLC
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Dates
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Enumeration Date | 10/08/2010
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Last Update Date | 10/08/2010
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Provider Practice Location Address
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Address Line | 11740 COLUMBIA ST
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City | BLAKELY
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State | GA
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Zip | 39823-2574
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Country | US
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Telephone | 229-723-4241
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Fax |
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Provider Business Mailing Address
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Address Line | 11740 COLUMBIA ST
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City | BLAKELY
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State | GA
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Zip | 39823-2574
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Country | US
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Telephone | 229-723-4241
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JOSEPH S MCNULTY III
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Credential |
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Telephone | 601-849-6440
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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 | 049-04
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License Number State | GA
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