Provider Demographics
NPI:1982674636
Name:METRO ATLANTA AMBULANCE SERVICES INC
Entity Type:Organization
Organization Name:METRO ATLANTA AMBULANCE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:E
Authorized Official - Last Name:QUINONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-693-8445
Mailing Address - Street 1:PO BOX 4130
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30061-4130
Mailing Address - Country:US
Mailing Address - Phone:770-693-8484
Mailing Address - Fax:770-693-8481
Practice Address - Street 1:1120 ALLGOOD INDUSTRIAL CT
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30066-6640
Practice Address - Country:US
Practice Address - Phone:770-693-8484
Practice Address - Fax:770-693-8481
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-25
Last Update Date:2016-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA03341341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA590014776OtherRAILROAD MEDICARE
GA000910555AMedicaid
GA59RCBLPMedicare ID - Type Unspecified