Medstar EMS LLC

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

MEDSTAR EMS LLC

Practice address

8321 Office Park Dr
Douglasville, GA 30134-6936

Phone

(404) 319-6038

NPI assigned

Jan 24, 2019

Organization subpart

No

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

Authorized official

Name

Glen F Vann

Title

President/Ceo

Phone

(404) 319-6038

Specialties & licenses 1

Addresses

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": "1548288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586908800000",
    "number": "1467916387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1375 PRITCHETT INDUSTRIAL BLVD",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301685520",
            "telephone_number": "404-319-6038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8321 OFFICE PARK DR",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301346936",
            "telephone_number": "404-319-6038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDSTAR EMS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-24",
        "last_updated": "2020-04-15",
        "certification_date": "2020-04-15",
        "status": "A",
        "authorized_official_last_name": "VANN",
        "authorized_official_first_name": "GLEN",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "404-319-6038"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donald Thomas Meadows, RPH, MBA
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• Mentor One
• Thaedra Denice Mercadel, M.D.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2020; 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.