Provider Demographics
NPI:1982252193
Name:LIFE EMERGENCY MEDICAL SERVICES, LLC.
Entity Type:Organization
Organization Name:LIFE EMERGENCY MEDICAL SERVICES, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WALKER
Authorized Official - Middle Name:
Authorized Official - Last Name:WADDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-539-3146
Mailing Address - Street 1:PO BOX 207
Mailing Address - Street 2:
Mailing Address - City:COMMERCE
Mailing Address - State:GA
Mailing Address - Zip Code:30529-0004
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:212 POWERS FERRY RD SE
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30067-7560
Practice Address - Country:US
Practice Address - Phone:404-539-3146
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-30
Last Update Date:2019-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport