Provider Demographics
NPI:1649744459
Name:SOUTHERN CARE EMS LLC
Entity Type:Organization
Organization Name:SOUTHERN CARE EMS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EFFREN
Authorized Official - Middle Name:
Authorized Official - Last Name:BIGHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-500-1039
Mailing Address - Street 1:PO BOX 2773
Mailing Address - Street 2:
Mailing Address - City:FOREST PARK
Mailing Address - State:GA
Mailing Address - Zip Code:30298-2773
Mailing Address - Country:US
Mailing Address - Phone:404-379-7605
Mailing Address - Fax:229-888-6876
Practice Address - Street 1:4010 NORTHSIDE DR STE F
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31210-1692
Practice Address - Country:US
Practice Address - Phone:404-379-7605
Practice Address - Fax:229-888-6876
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-15
Last Update Date:2019-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport