Provider Demographics
NPI:1063843597
Name:TRINITY EMS LLC
Entity Type:Organization
Organization Name:TRINITY EMS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:CORMIER
Authorized Official - Suffix:
Authorized Official - Credentials:EMT-I
Authorized Official - Phone:770-709-1462
Mailing Address - Street 1:155 WESTRIDGE PKWY
Mailing Address - Street 2:SUITE 210
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30253-3051
Mailing Address - Country:US
Mailing Address - Phone:770-914-8803
Mailing Address - Fax:770-914-8949
Practice Address - Street 1:155 WESTRIDGE PKWY
Practice Address - Street 2:SUITE 210
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30253-3051
Practice Address - Country:US
Practice Address - Phone:770-914-8803
Practice Address - Fax:770-914-8949
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-10
Last Update Date:2013-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA075-133416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport