Provider Demographics
NPI:1891005666
Name:EMERGENCY MEDICAL SERVICES, LLC
Entity Type:Organization
Organization Name:EMERGENCY MEDICAL SERVICES, LLC
Other - Org Name:MEDTREK EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PERRY
Authorized Official - Middle Name:R
Authorized Official - Last Name:HUSKEY
Authorized Official - Suffix:JR
Authorized Official - Credentials:PARAMEDIC
Authorized Official - Phone:706-864-6586
Mailing Address - Street 1:81 CROWN MOUNTAIN PL
Mailing Address - Street 2:A-100
Mailing Address - City:DAHLONEGA
Mailing Address - State:GA
Mailing Address - Zip Code:30533-1627
Mailing Address - Country:US
Mailing Address - Phone:706-864-6586
Mailing Address - Fax:404-393-1917
Practice Address - Street 1:81 CROWN MOUNTAIN PL
Practice Address - Street 2:A-100
Practice Address - City:DAHLONEGA
Practice Address - State:GA
Practice Address - Zip Code:30533-1627
Practice Address - Country:US
Practice Address - Phone:706-864-6586
Practice Address - Fax:404-393-1917
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-14
Last Update Date:2016-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAMB20160013416L0300X
GA060-71341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Yes3416L0300XTransportation ServicesAmbulanceLand Transport