Provider Demographics
NPI:1659723054
Name:OPEN ARMS EMS LLC
Entity Type:Organization
Organization Name:OPEN ARMS EMS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:T
Authorized Official - Last Name:GRAVES
Authorized Official - Suffix:
Authorized Official - Credentials:BLS
Authorized Official - Phone:470-278-1001
Mailing Address - Street 1:119 CASTLEWOOD RD
Mailing Address - Street 2:
Mailing Address - City:TYRONE
Mailing Address - State:GA
Mailing Address - Zip Code:30290-2224
Mailing Address - Country:US
Mailing Address - Phone:470-278-1001
Mailing Address - Fax:
Practice Address - Street 1:119 CASTLEWOOD RD
Practice Address - Street 2:
Practice Address - City:TYRONE
Practice Address - State:GA
Practice Address - Zip Code:30290-2224
Practice Address - Country:US
Practice Address - Phone:470-278-1001
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-08
Last Update Date:2016-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAMB20160073416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport