Provider Demographics
NPI:1588345219
Name:DESTINEY EMERGENCY MEDICAL SERVICES LLC
Entity type:Organization
Organization Name:DESTINEY EMERGENCY MEDICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:EJIKE
Authorized Official - Middle Name:CHIKA
Authorized Official - Last Name:ANADU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-662-9961
Mailing Address - Street 1:3800 HOLCOMB BRIDGE RD # B1
Mailing Address - Street 2:
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30092-5218
Mailing Address - Country:US
Mailing Address - Phone:404-662-9961
Mailing Address - Fax:678-550-9688
Practice Address - Street 1:3800 HOLCOMB BRIDGE RD # B1
Practice Address - Street 2:
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30092-5218
Practice Address - Country:US
Practice Address - Phone:404-662-9961
Practice Address - Fax:678-550-9688
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-26
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3416L0300XTransportation ServicesAmbulanceLand TransportGroup - Single Specialty
No251E00000XAgenciesHome Health
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)Group - Single Specialty