Provider Demographics
NPI:1881821742
Name:CITY EMS OF GEORGIA LLC
Entity Type:Organization
Organization Name:CITY EMS OF GEORGIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:B
Authorized Official - Last Name:MOREE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-719-5337
Mailing Address - Street 1:165 CARNEGIE PL
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30214-3905
Mailing Address - Country:US
Mailing Address - Phone:770-389-3894
Mailing Address - Fax:770-719-2730
Practice Address - Street 1:165 CARNEGIE PL
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30214-3905
Practice Address - Country:US
Practice Address - Phone:770-389-3894
Practice Address - Fax:770-719-2730
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-18
Last Update Date:2013-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport