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General NPI Number Information
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NPI Number | 1972802601
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Entity Type | Organization
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Legal Business Name | AMBULANCE SERVICE MANAGEMENT, LLC
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Dates
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Enumeration Date | 03/21/2011
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Last Update Date | 12/11/2013
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Provider Practice Location Address
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Address Line | 2305 DANBURY LN SUITE C
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City | GAINESVILLE
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State | GA
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Zip | 30507-7311
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Country | US
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Telephone | 678-343-2020
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Fax |
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Provider Business Mailing Address
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Address Line | 2305 DANBURY LN SUITE C
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City | GAINESVILLE
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State | GA
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Zip | 30507-7311
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Country | US
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Telephone | 678-343-2020
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | MR. LEONARD HOWELL COLEMAN III
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Credential |
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Telephone | 678-343-2020
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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 | 069-23
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License Number State | GA
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