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General NPI Number Information
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NPI Number | 1992038517
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Entity Type | Organization
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Legal Business Name | EXCELCARE AMBULANCE SERVICE, INC
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Dates
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Enumeration Date | 09/15/2009
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Last Update Date | 09/15/2009
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Provider Practice Location Address
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Address Line | 331 S MAIN ST
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City | BAXLEY
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State | GA
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Zip | 31513-0109
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Country | US
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Telephone | 877-399-1018
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Fax | 912-367-6233
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Provider Business Mailing Address
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Address Line | 331 S MAIN ST
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City | BAXLEY
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State | GA
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Zip | 31513-0109
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Country | US
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Telephone | 877-399-1018
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Fax | 912-367-6233
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Authorized Official
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Title or Position | CEO
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Name | DR. JAMES ADRIAN GRAHAM
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Credential | M.D.
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Telephone | 912-278-2888
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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 | 001-02
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License Number State | GA
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