Provider Demographics
NPI:1629582267
Name:EASYMED EMS LLC
Entity Type:Organization
Organization Name:EASYMED EMS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:EMANUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:OKAFOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-262-2005
Mailing Address - Street 1:355 TALL OAKS DR SE
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30013-1670
Mailing Address - Country:US
Mailing Address - Phone:770-268-1098
Mailing Address - Fax:770-819-8001
Practice Address - Street 1:355 TALL OAKS DR SE
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30013-1670
Practice Address - Country:US
Practice Address - Phone:770-389-4774
Practice Address - Fax:770-819-8001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-17
Last Update Date:2018-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
G2351OtherGEORGIA