MEDICARE: INTEGRITY 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	AMB2017010	GA

General Provider Information

NPI Number	:	1720510704
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTEGRITY EMS LLC

Provider Business Mailing Address
First Line	:	3276 BUFORD DR STE 104-375
Second Line	:
City	:	BUFORD
State	:	GA
Zip	:	30519-5702
Country	:	US
Telephone Number	:	832-643-2993
Fax Number	:

Provider Business Practice Location Address
First Line	:	2710 JEFFERSON ST
Second Line	:	SUITE 1
City	:	AUSTELL
State	:	GA
Zip	:	30168-4050
Country	:	US
Telephone Number	:	470-399-0011
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	NAIEF ABUKHALID
Credential	:
Telephone Number	:	832-643-2993

Provider Enumeration Date	:	03/30/2017
Last Update Date	:	03/30/2017

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