Provider Demographics
NPI:1639972110
Name:SOUTHERN AUGMENTATION LIMITED COMPANY
Entity type:Organization
Organization Name:SOUTHERN AUGMENTATION LIMITED COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ LEAD ADMINISTRATIVE LIASON
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMERON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-326-3574
Mailing Address - Street 1:1737 GRAHAM RD APT S1
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31211-1068
Mailing Address - Country:US
Mailing Address - Phone:323-326-3574
Mailing Address - Fax:323-326-3574
Practice Address - Street 1:1737 GRAHAM RD APT S1
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31211-1068
Practice Address - Country:US
Practice Address - Phone:323-326-3574
Practice Address - Fax:323-326-3574
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-31
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)