Provider Demographics
NPI:1215743737
Name:REGIONAL MEDICAL EMS LLC
Entity type:Organization
Organization Name:REGIONAL MEDICAL EMS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:FLOYD
Authorized Official - Last Name:LACOSTE
Authorized Official - Suffix:
Authorized Official - Credentials:NA
Authorized Official - Phone:404-576-0964
Mailing Address - Street 1:4046 HIGHWAY 154 STE 228
Mailing Address - Street 2:
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30265-2330
Mailing Address - Country:US
Mailing Address - Phone:404-576-0964
Mailing Address - Fax:
Practice Address - Street 1:4046 HIGHWAY 154 STE 228
Practice Address - Street 2:
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30265-2330
Practice Address - Country:US
Practice Address - Phone:404-576-0964
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-09
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulance