Southern Prestige EMS, LLC

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

SOUTHERN PRESTIGE EMS, LLC

Practice address

613 Lake Shore Dr
Morganton, GA 30560-3561

Phone

(706) 633-0730

NPI assigned

Jun 5, 2014

Organization subpart

No

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

Authorized official

Name

David Ryan McDaris, PARAMEDIC

Title

Ceo/Paramedic

Phone

(706) 633-3819

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1401926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401926400000",
    "number": "1457764557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "613 LAKE SHORE DR",
            "city": "MORGANTON",
            "state": "GA",
            "postal_code": "305603561",
            "telephone_number": "706-633-0730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "613 LAKE SHORE DR",
            "city": "MORGANTON",
            "state": "GA",
            "postal_code": "305603561",
            "telephone_number": "706-633-0730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN PRESTIGE EMS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-05",
        "last_updated": "2014-06-05",
        "status": "A",
        "authorized_official_last_name": "MCDARIS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "RYAN",
        "authorized_official_title_or_position": "CEO/PARAMEDIC",
        "authorized_official_telephone_number": "706-633-3819",
        "authorized_official_credential": "PARAMEDIC"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2014; 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.