Provider Demographics
NPI:1598309817
Name:1ST CHOICE AMBULANCE SERVICE, LLC
Entity Type:Organization
Organization Name:1ST CHOICE AMBULANCE SERVICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DESMOND
Authorized Official - Middle Name:
Authorized Official - Last Name:NEWKIRK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-780-5532
Mailing Address - Street 1:185 BRADFORD SQ STE C
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30215-1932
Mailing Address - Country:US
Mailing Address - Phone:770-780-5532
Mailing Address - Fax:
Practice Address - Street 1:185 BRADFORD SQ STE C
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30215-1932
Practice Address - Country:US
Practice Address - Phone:770-780-5532
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-30
Last Update Date:2019-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance