Bulloch County Emergency Medical Service

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

01602 Issued in GA

Legal business name

BULLOCH COUNTY EMERGENCY MEDICAL SERVICE

Practice address

26 W Grady St
Statesboro, GA 30458-2742

Phone

(912) 764-6188

Fax

(912) 489-8917

NPI assigned

Aug 25, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Douglas C Vickers

Title

Interim Director

Phone

(912) 764-6188

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kelli Akins

  • Paramedic
  • Statesboro, GA
  • NPI 1285036467
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357689600000",
    "number": "1013025642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1409",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304591409",
            "telephone_number": "912-764-6188",
            "fax_number": "912-489-8917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 W GRADY ST",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304582742",
            "telephone_number": "912-764-6188",
            "fax_number": "912-489-8917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BULLOCH COUNTY EMERGENCY MEDICAL SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-25",
        "last_updated": "2013-01-09",
        "status": "A",
        "authorized_official_last_name": "VICKERS",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "INTERIM DIRECTOR",
        "authorized_official_telephone_number": "912-764-6188",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "GA",
            "license": "01602",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00263227A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daniel B Bullman, CHW/CRS
• Bulloch Chiropractic
• Bulloch County Board Education
• Bulloch County Board of Health
• Bulloch County Board of Health
• Bulloch County Endoscopy Center, LLC
• Bulloch County Health Care LLC
• Bulloch County LTC LLC
• Bulloch County LTC, LLC
• Bulloch County LTC, LLC

• Land Ambulance in Statesboro, GA
• Providers in Statesboro, GA by specialty
• Land Ambulance in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.