MEDICARE: GEORGIA-LINA EMS, LLC

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	:	1437778883
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GEORGIA-LINA EMS, LLC

Provider Business Mailing Address
First Line	:	PO BOX 15755
Second Line	:
City	:	AUGUSTA
State	:	GA
Zip	:	30919-1755
Country	:	US
Telephone Number	:	706-434-4021
Fax Number	:

Provider Business Practice Location Address
First Line	:	1109 MEDICAL CENTER DR STE 4
Second Line	:
City	:	AUGUSTA
State	:	GA
Zip	:	30909-6641
Country	:	US
Telephone Number	:	706-434-4021
Fax Number	:

Authorized Official
Title or Position	:	BILLING MANAGER
Name	:	CAREY L STORY
Credential	:
Telephone Number	:	706-434-4018

Provider Enumeration Date	:	04/15/2020
Last Update Date	:	03/04/2026

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