| Organization Name: | EMERGENCY MEDICAL SERVICE OF RANDOLPH COUNTY GA |
| NPI Number: | 1124079389 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ELLETTE JACKSON (EMS DIRECTOR) |
| Mailing Address: | 34 Taylor Street Cuthbert |
| State: | GA US |
| Postal Code: | 398401338 |
| Phone Number: | 2297326632 |
| Fax Number: | 2297322139 |
| NPI Enumeration Date: | 05/13/2006 |
| NPI Last Update Date: | 11/29/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 3416L0300X |
| License Number: | 12001 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Transportation Services |
| Taxonomy Classification: | Ambulance |
| Taxonomy Specialization: | Land Transport |
| Taxonomy Definition: | |