Provider Demographics
NPI:1184394447
Name:EAST METRO EMT SERVICES LLC
Entity type:Organization
Organization Name:EAST METRO EMT SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:
Authorized Official - Last Name:BACKMON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-849-9419
Mailing Address - Street 1:5658 REX RIDGE LOOP
Mailing Address - Street 2:
Mailing Address - City:REX
Mailing Address - State:GA
Mailing Address - Zip Code:30273-5237
Mailing Address - Country:US
Mailing Address - Phone:404-849-9419
Mailing Address - Fax:
Practice Address - Street 1:2385 WALL ST SE STE 208-B
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30013-2187
Practice Address - Country:US
Practice Address - Phone:404-849-9419
Practice Address - Fax:678-669-2942
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-17
Last Update Date:2021-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance