Provider Demographics
NPI:1144346958
Name:GEMINI EMS, LLC
Entity type:Organization
Organization Name:GEMINI EMS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:PRINCE
Authorized Official - Suffix:
Authorized Official - Credentials:EMT-I
Authorized Official - Phone:678-289-2200
Mailing Address - Street 1:3230 N HENRY BLVD
Mailing Address - Street 2:SUITE F
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-4667
Mailing Address - Country:US
Mailing Address - Phone:678-289-2200
Mailing Address - Fax:
Practice Address - Street 1:3230 N HENRY BLVD
Practice Address - Street 2:SUITE F
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-4667
Practice Address - Country:US
Practice Address - Phone:678-289-2200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA075-073416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport