Provider Demographics
NPI:1609859818
Name:JASPER COUNTY EMERGENCY MEDICAL SERVICE
Entity Type:Organization
Organization Name:JASPER COUNTY EMERGENCY MEDICAL SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:FINCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-603-8915
Mailing Address - Street 1:126 W. GREENE ST.
Mailing Address - Street 2:SUITE 031
Mailing Address - City:MONTICELLO
Mailing Address - State:GA
Mailing Address - Zip Code:31064-1171
Mailing Address - Country:US
Mailing Address - Phone:706-468-1091
Mailing Address - Fax:706-468-5010
Practice Address - Street 1:185 HIGHWAY 212 W
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:GA
Practice Address - Zip Code:31064-0000
Practice Address - Country:US
Practice Address - Phone:706-468-4943
Practice Address - Fax:706-468-4939
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-22
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA079-023416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000005684AMedicaid
GA000005684AMedicaid