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General NPI Number Information
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NPI Number | 1619521366
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Entity Type | Organization
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Legal Business Name | SURE CARE EMS
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Dates
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Enumeration Date | 07/31/2019
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Last Update Date | 10/02/2019
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Provider Practice Location Address
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Address Line | 2136 W PARK CT BLDG 2
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City | STONE MOUNTAIN
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State | GA
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Zip | 30087-3528
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Country | US
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Telephone | 404-996-4182
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Fax |
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Provider Business Mailing Address
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Address Line | 2136 W PARK CT BLDG 2
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City | STONE MOUNTAIN
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State | GA
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Zip | 30087-3528
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Country | US
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Telephone | 404-996-4182
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Fax |
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Authorized Official
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Title or Position | OWNER/OPEARATIONS MANAGER
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Name | MR. ANDRE GRANT
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Credential |
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Telephone | 404-389-3021
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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 |
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License Number State |
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