Braveheart Medical Response LLC

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

AMB2017007 Issued in GA

Legal business name

BRAVEHEART MEDICAL RESPONSE LLC

Practice address

650 Hillcrest Rd NW
Suite 100
Lilburn, GA 30047-1711

Phone

(770) 802-4700

Fax

(770) 802-4702

NPI assigned

Mar 27, 2017

Organization subpart

No

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

Authorized official

Name

Bernadette Moore

Title

President

Phone

(770) 802-4700

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1490572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572220800000",
    "number": "1558892000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "528 FOREST PKWY STE E",
            "city": "FOREST PARK",
            "state": "GA",
            "postal_code": "302976109",
            "telephone_number": "404-366-5298",
            "fax_number": "404-366-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 HILLCREST RD NW",
            "address_2": "SUITE 100",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300471711",
            "telephone_number": "770-802-4700",
            "fax_number": "770-802-4702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAVEHEART MEDICAL RESPONSE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-27",
        "last_updated": "2019-10-28",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "BERNADETTE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-802-4700"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "GA",
            "license": "AMB2017007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marcus Bradley
• Tonya L Brailey
• Brain and Soul Wellness Group, LLC
• James Palmer Branch, D.P.M
• William George Brandenburg, DDS
• Karen Bridges, RPH
• Rebecca L Brigola, APNP
• Michael James Brissett, PH.D.
• Alan D Brown Jr., O.D.
• Roselyn Burton Brown, PA-C

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2019; 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.