MEDICARE: 1ST RESPONDERS 2 EMS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	341600000X	Ambulance

General Provider Information

NPI Number	:	1114491438
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	1ST RESPONDERS 2 EMS

Provider Business Mailing Address
First Line	:	155 WESTRIDGE PKWY STE 113
Second Line	:
City	:	MCDONOUGH
State	:	GA
Zip	:	30253-3050
Country	:	US
Telephone Number	:	678-782-3032
Fax Number	:

Provider Business Practice Location Address
First Line	:	155 WESTRIDGE PKWY STE 113
Second Line	:
City	:	MCDONOUGH
State	:	GA
Zip	:	30253-3050
Country	:	US
Telephone Number	:	678-782-3032
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	HANZ FEQUIERE
Credential	:
Telephone Number	:	678-592-2656

Provider Enumeration Date	:	01/21/2019
Last Update Date	:	01/21/2019

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Directions to “1ST RESPONDERS 2 EMS ” Practice Location

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