EMERGENCY MEDICAL SERVICE OF RANDOLPH COUNTY GA (NPI# 1124079389) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124079389 |
| Entity Type | Organization |
| Organization Name | EMERGENCY MEDICAL SERVICE OF RANDOLPH COUNTY GA |
| Practice Address |
34 Taylor Street Cuthbert GA 39840-1338 |
| Mailing Address |
361 Randolph Street Cuthbert GA 39840-1338 |
| Practice Telephone | 2297326632 |
| Practice Fax Number | 2297322139 |
| Mailing Telephone | 2297326632 |
| Mailing Fax Number | 2297322139 |
| Enumeration Date | 2006-05-13 |
| Last Update Date | 2010-11-29 |
| Authorized Official Name | MR. ELLETTE JACKSON (EMS DIRECTOR) |
| Authorized Official Telephone | 2297326632 |
| Authorized Official Credential | PARAMEDIC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3416L0300X |
Ambulance Specialization: Land Transport |
12001 | GA | Transportation Services |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000002593A | 05 |
| Street Address |
34 TAYLOR STREET |
| City | CUTHBERT |
| State | GA |
| Zip Code | 39840-1338 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366867533 | Rashema Vandetta Warren | Case Manager/Care Coordinator | 90 Villa Nova Street, New Horizons, Cuthbert, GA 39840 | 2014-02-25 |
| 1417378415 | Temperess Johnson | Adult Companion | 72 Cleborne Street, Cuthbert, GA 39840 | 2013-12-18 |
| 1730500976 | Mary Gibbs | Case Manager/Care Coordinator | 72 Clebourne Street, Cuthbert, GA 39840 | 2013-12-13 |
| 1023448917 | Katie Wright | Counselor | 72 Clebourne St, Cuthbert, GA 39840 | 2013-11-14 |
| 1588952048 | Michael Carr Jr. | Dentist | 84 Court Street, Cuthbert, GA 39840 | 2011-07-19 |
| 1518286764 | Lisa Ann Hardwick | Occupational Therapy Assistant | 2058 Hghway 82, Cuthbuert, GA 39840 | 2010-05-27 |
| 1952630154 | Naomi S Jenkins | Counselor | 264 Lumpkin Street, Cuthbert, GA 39840 | 2009-12-17 |
| 1467647875 | Mental Retardation Waiver Program | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 119 Claborn St., Cuthbert, GA 39840 | 2007-09-10 |
| 1376614073 | Randolph County Coutny School System | Local Education Agency (LEA) | 3451 Ga Hwy 266, Cuthbert, GA 39840 | 2006-11-13 |
| 1437632890 | Gary Nell Glover | Community Health Worker | 72 Clebourne Street, Cuthbert, GA 39840 | 2018-09-12 |
| Find all providers in zip 39840 | ||||
| Taxonomy Code | 3416L0300X |
| Grouping | Transportation Services |
| Classification | Ambulance |
| Specialization | Land Transport |
| Definition to come... |
| Notes: [1/1/2005: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487254660 | South Ga Ambulance LLC | Ambulance | 855 W Golden Isles Hwy, Mc Rae Helena, GA 31037-3914 | 2020-10-28 |
| 1013521491 | Hla Ambulance LLC | Ambulance | 43 Amanda Ln, Palmetto, GA 30268 | 2020-09-03 |
| 1508479502 | Alliance Transportation Services | Ambulance | 247 Carlyle Park Dr Ne, Atlanta, GA 30307-2883 | 2020-08-28 |
| 1942812714 | Sagrada Ambulance LLC | Ambulance | 300 W I Pkwy # 203, Dallas, GA 30132-5079 | 2020-08-21 |
| 1689286866 | Med-trak LLC | Ambulance | 2395 Wall St Se Ste 195, Conyers, GA 30013-6703 | 2020-08-19 |
| 1952929523 | Hope Medical Transport Services | Ambulance | 101 Park 42 Dr Ste F, Locust Grove, GA 30248-2559 | 2020-07-10 |
| 1750908372 | 1st Class Ambulance | Ambulance | 5515 Riverdale Rd Ste B, College Park, GA 30349-6449 | 2020-06-30 |
| 1518588250 | B and D Medical Transportation | Ambulance | 8687 Hospital Dr Ste 104, Douglasville, GA 30134-5615 | 2020-05-05 |
| 1043831241 | Health Investment Group Inc | Ambulance | 1331 Wynnton Ct, Columbus, GA 31906-2140 | 2020-04-29 |
| 1760002653 | Express Medical Transportation | Ambulance | 7350 Hwy 106 South, Ste C, Hull, GA 30646 | 2020-04-21 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on EMERGENCY MEDICAL SERVICE OF RANDOLPH COUNTY GA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.