Medex of Georgia Inc

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

075-11 Issued in GA

Legal business name

MEDEX OF GEORGIA INC

Practice address

101 Bellamy PL
Stockbridge, GA 30281-4458

Phone

(678) 565-6339

Fax

(678) 565-6331

NPI assigned

Feb 21, 2013

Organization subpart

No

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

Authorized official

Name

Mr. Travis Mitchell Kirkland

Title

President

Phone

(478) 737-0094

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1361404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384992000000",
    "number": "1184964587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 BELLAMY PL",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302814458",
            "telephone_number": "678-565-6339",
            "fax_number": "678-565-6331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 BELLAMY PL",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302814458",
            "telephone_number": "678-565-6339",
            "fax_number": "678-565-6331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDEX OF GEORGIA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-21",
        "last_updated": "2013-11-21",
        "status": "A",
        "authorized_official_last_name": "KIRKLAND",
        "authorized_official_first_name": "TRAVIS",
        "authorized_official_middle_name": "MITCHELL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "478-737-0094",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "GA",
            "license": "075-11",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.