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General NPI Number Information
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NPI Number | 1952754129
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Entity Type | Organization
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Legal Business Name | OPEN ARMS EMS
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Dates
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Enumeration Date | 07/22/2016
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Last Update Date | 07/22/2016
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Provider Practice Location Address
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Address Line | 1350 S ZACK HINTON PKWY
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City | MCDONOUGH
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State | GA
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Zip | 30253-3361
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Country | US
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Telephone | 470-278-1001
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Fax | 470-278-1039
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Provider Business Mailing Address
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Address Line | 1350 S ZACK HINTON PKWY
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City | MCDONOUGH
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State | GA
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Zip | 30253-3361
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Country | US
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Telephone | 470-278-1001
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Fax | 470-278-1039
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Authorized Official
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Title or Position | OWNER
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Name | ROBERT T GRAVES
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Credential | PARAMEDIC
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Telephone | 770-823-7940
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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 | AMB2016007
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License Number State | GA
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