Provider Demographics
NPI:1760146252
Name:SPARTAN EMS LLC
Entity Type:Organization
Organization Name:SPARTAN EMS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:SEAN
Authorized Official - Last Name:HULSEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-530-4355
Mailing Address - Street 1:3455 LEISURE LN
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30506-3715
Mailing Address - Country:US
Mailing Address - Phone:770-530-4355
Mailing Address - Fax:
Practice Address - Street 1:3455 LEISURE LN
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30506-3715
Practice Address - Country:US
Practice Address - Phone:770-530-4355
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-29
Last Update Date:2021-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance