Provider Demographics
NPI:1033469192
Name:HOPE AMBULANCE LLC
Entity type:Organization
Organization Name:HOPE AMBULANCE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JACKIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ELLINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:EMT-I
Authorized Official - Phone:706-889-8199
Mailing Address - Street 1:P.O. BOX 1725
Mailing Address - Street 2:
Mailing Address - City:ELLIJAY
Mailing Address - State:GA
Mailing Address - Zip Code:30540-0033
Mailing Address - Country:US
Mailing Address - Phone:886-213-1275
Mailing Address - Fax:706-273-7476
Practice Address - Street 1:1548 OLD HWY 5 SOUTH
Practice Address - Street 2:
Practice Address - City:ELLIJAY
Practice Address - State:GA
Practice Address - Zip Code:30540-5938
Practice Address - Country:US
Practice Address - Phone:866-213-1275
Practice Address - Fax:706-273-7476
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-17
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA061-053416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport