City of Forest Park

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

03105 Issued in GA

Legal business name

CITY OF FOREST PARK

Practice address

4539 Jonesboro Rd
Forest Park, GA 30297-3542

Phone

(404) 608-2383

Fax

(404) 608-2385

NPI assigned

Dec 6, 2005

Last updated

Jun 26, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Alfred Smith

Title

Interim EMS Director

Phone

(470) 947-2194

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

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

{
    "created_epoch": "1133827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750896000000",
    "number": "1255315800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4539 JONESBORO RD",
            "city": "FOREST PARK",
            "state": "GA",
            "postal_code": "302973542",
            "telephone_number": "404-608-2373",
            "fax_number": "404-608-2385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4539 JONESBORO RD",
            "city": "FOREST PARK",
            "state": "GA",
            "postal_code": "302973542",
            "telephone_number": "404-608-2383",
            "fax_number": "404-608-2385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF FOREST PARK",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-06",
        "last_updated": "2025-06-26",
        "certification_date": "2025-06-26",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "ALFRED",
        "authorized_official_title_or_position": "INTERIM EMS DIRECTOR",
        "authorized_official_telephone_number": "470-947-2194"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "GA",
            "license": "03105",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000243933A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Land Ambulance in Forest Park, GA
• Providers in Forest Park, GA by specialty
• Land Ambulance in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2025; 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.