Provider Demographics
NPI:1740585595
Name:SOUTHERN AMBULANCE SERVICE LTD
Entity Type:Organization
Organization Name:SOUTHERN AMBULANCE SERVICE LTD
Other - Org Name:SOUTH STAR EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CAREY
Authorized Official - Middle Name:L
Authorized Official - Last Name:STORY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-434-4018
Mailing Address - Street 1:4328 WHEELER RD
Mailing Address - Street 2:
Mailing Address - City:MARTINEZ
Mailing Address - State:GA
Mailing Address - Zip Code:30907-9740
Mailing Address - Country:US
Mailing Address - Phone:706-434-4000
Mailing Address - Fax:706-396-2100
Practice Address - Street 1:139 EDGEFIELD RD
Practice Address - Street 2:
Practice Address - City:NORTH AUGUSTA
Practice Address - State:SC
Practice Address - Zip Code:29841-2423
Practice Address - Country:US
Practice Address - Phone:706-434-4000
Practice Address - Fax:706-396-2100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-25
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport