Provider Demographics
NPI:1902191935
Name:FAITH MEDICAL SERVICES
Entity Type:Organization
Organization Name:FAITH MEDICAL SERVICES
Other - Org Name:JULIE MARTIN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:7705-333-2673
Mailing Address - Street 1:955 J2 INTERSTATE RIDGE DRIVE
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30501
Mailing Address - Country:US
Mailing Address - Phone:770-533-2673
Mailing Address - Fax:770-534-6843
Practice Address - Street 1:955 J2 INTERSTATE RIDGE DRIVE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501
Practice Address - Country:US
Practice Address - Phone:770-533-2673
Practice Address - Fax:770-534-6843
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FAITH MEDICAL AMBULANCE SERVICE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-06-17
Last Update Date:2013-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA069-0223416L0300X
GA343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)