MEDICARE: ATRIUM HEALTH FORT MILL EMS, INC.

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	3416L0300X	Land Ambulance

General Provider Information

NPI Number	:	1124833603
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ATRIUM HEALTH FORT MILL EMS, INC.

Provider Business Mailing Address
First Line	:	PO BOX 32861
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28232-2861
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	216 S WHITE ST
Second Line	:
City	:	FORT MILL
State	:	SC
Zip	:	29715-2154
Country	:	US
Telephone Number	:	803-548-1456
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JONATHAN M. COLLIER
Credential	:
Telephone Number	:	208-515-6470

Provider Enumeration Date	:	02/11/2025
Last Update Date	:	02/11/2025

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