Provider Demographics
NPI:1427336551
Name:MED SOUTH EMS INC
Entity type:Organization
Organization Name:MED SOUTH EMS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CARL
Authorized Official - Middle Name:J
Authorized Official - Last Name:KINDLEY
Authorized Official - Suffix:
Authorized Official - Credentials:EMT INTERMEDIATE
Authorized Official - Phone:404-768-4800
Mailing Address - Street 1:PO BOX 278
Mailing Address - Street 2:
Mailing Address - City:SENOIA
Mailing Address - State:GA
Mailing Address - Zip Code:30276-0278
Mailing Address - Country:US
Mailing Address - Phone:404-768-4800
Mailing Address - Fax:770-306-1001
Practice Address - Street 1:116 W 2ND AVE
Practice Address - Street 2:
Practice Address - City:COLBERT
Practice Address - State:GA
Practice Address - Zip Code:30628-2915
Practice Address - Country:US
Practice Address - Phone:404-768-4800
Practice Address - Fax:770-306-1001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-22
Last Update Date:2011-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA095033416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport