Provider Demographics
NPI:1912118969
Name:ROMINE, CHRIS (CEO)
Entity Type:Individual
Prefix:MR
First Name:CHRIS
Middle Name:
Last Name:ROMINE
Suffix:
Gender:M
Credentials:CEO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 326
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:GA
Mailing Address - Zip Code:30143-0326
Mailing Address - Country:US
Mailing Address - Phone:404-474-7024
Mailing Address - Fax:
Practice Address - Street 1:1580 APPALACHIAN HWY
Practice Address - Street 2:
Practice Address - City:BLUE RIDGE
Practice Address - State:GA
Practice Address - Zip Code:30513-4967
Practice Address - Country:US
Practice Address - Phone:404-474-7024
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA24801146M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146M00000XEmergency Medical Service ProvidersEmergency Medical Technician, Intermediate