Provider Demographics
NPI:1093168999
Name:CAPITAL CITY AMBULANCE OF GA
Entity Type:Organization
Organization Name:CAPITAL CITY AMBULANCE OF GA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:ADKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-829-7771
Mailing Address - Street 1:311 WHITLAWS RD
Mailing Address - Street 2:
Mailing Address - City:NORTH AUGUSTA
Mailing Address - State:SC
Mailing Address - Zip Code:29841-5700
Mailing Address - Country:US
Mailing Address - Phone:803-442-9426
Mailing Address - Fax:803-442-9024
Practice Address - Street 1:311 WHITLAWS RD
Practice Address - Street 2:
Practice Address - City:NORTH AUGUSTA
Practice Address - State:SC
Practice Address - Zip Code:29841-5700
Practice Address - Country:US
Practice Address - Phone:706-829-7771
Practice Address - Fax:803-442-9024
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3683416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport