Clark Ambulance Service

LBN: Clark Ems Ambulance Service
Clark Ambulance Service is an health care organization with primary practice located at 117A Commerce Dr , Dallas GA 30132. The organization recently has 3 registered licenses in different health care specialties including Emergency Medical Service Providers / Emergency Medical Technician, Paramedic, Emergency Medical Service Providers / Emergency Medical Technician, Intermediate, Emergency Medical Service Providers / Emergency Medical Technician, Basic. Emergency Medical Service Providers / Emergency Medical Technician, Paramedic is the primary health care specialty. Clark Ems Ambulance Service can be contacted via phone (770) 445-2151, or through Clark, Samuel T via phone (770) 445-5008.

Contact Information

Primary practice address
117A Commerce Dr Dallas GA 30132
Phone: (770) 445-2151
Fax: (770) 943-2855
Website:
Map and Directions
Authorized official contact:
Name: Clark, Samuel T OWNER
Phone: (770) 445-5008

Health care specialties

SpecialtyCodeLicense #State
Emergency Medical Service Providers / Emergency Medical Technician, Paramedic 146L00000X 11006 Georgia
Emergency Medical Service Providers / Emergency Medical Technician, Intermediate 146M00000X 11006 Georgia
Emergency Medical Service Providers / Emergency Medical Technician, Basic 146N00000X 11006 Georgia

Profile Details

NPI number 1952498776
LBN Legal business name Clark Ems Ambulance Service
DBA Doing business as Clark Ambulance Service
Authorized official Clark, Samuel T OWNER
Entity Organization
Organization subpart 1 No
Enumeration date Oct 5th, 2006
Last updated Feb 1st, 2013 - about 11 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1952498776 NPPES
Georgia Other 590014898 RAILROAD MEDICARE
Georgia MEDICAID 00311165A RAILROAD MEDICARE

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