Provider Demographics
NPI:1679572598
Name:GARLOCK ENTERPRISES
Entity Type:Organization
Organization Name:GARLOCK ENTERPRISES
Other - Org Name:GEMS AMBULANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JORICA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:PEAVY
Authorized Official - Suffix:
Authorized Official - Credentials:BILLER
Authorized Official - Phone:334-383-9894
Mailing Address - Street 1:29 LV STABLER DRIVE
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36037
Mailing Address - Country:US
Mailing Address - Phone:334-383-9894
Mailing Address - Fax:334-383-2221
Practice Address - Street 1:108 LV STABLER DRIVE
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:AL
Practice Address - Zip Code:36037
Practice Address - Country:US
Practice Address - Phone:334-383-9908
Practice Address - Fax:334-383-2221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-21
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL7863416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR590013557OtherRAILROAD MEDICARE
AL590013557OtherRAILROAD MEDICARE
AL000022277Medicaid
AL1679572598Medicaid