Provider Demographics
NPI:1700394624
Name:SOUTHMED EMS, LLC
Entity Type:Organization
Organization Name:SOUTHMED EMS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CUSE
Authorized Official - Middle Name:
Authorized Official - Last Name:DIGI'AMO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-334-4561
Mailing Address - Street 1:212 POWERS FERRY RD SE
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30067-7560
Mailing Address - Country:US
Mailing Address - Phone:202-390-8488
Mailing Address - Fax:
Practice Address - Street 1:604 SEMINOLE DR NE
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-1510
Practice Address - Country:US
Practice Address - Phone:404-334-4561
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-12
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport