Provider Demographics
NPI:1134156045
Name:HAMILTON EMERGENCY MEDICAL SERVICES
Entity type:Organization
Organization Name:HAMILTON EMERGENCY MEDICAL SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:SHAWNA
Authorized Official - Middle Name:G
Authorized Official - Last Name:FARMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-278-9211
Mailing Address - Street 1:1105 MEMORIAL DR
Mailing Address - Street 2:P. O. BOX 806
Mailing Address - City:DALTON
Mailing Address - State:GA
Mailing Address - Zip Code:30720-8742
Mailing Address - Country:US
Mailing Address - Phone:706-278-9111
Mailing Address - Fax:706-279-2923
Practice Address - Street 1:1105 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:DALTON
Practice Address - State:GA
Practice Address - Zip Code:30720-8742
Practice Address - Country:US
Practice Address - Phone:706-278-9111
Practice Address - Fax:706-279-2923
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-27
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA155073416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00315851AMedicaid
GA85054059AAMedicare ID - Type UnspecifiedPROVIDER #