CLARK EMS AMBULANCE SERVICE (NPI# 1952498776) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952498776 |
| Entity Type | Organization |
| Organization Name | CLARK EMS AMBULANCE SERVICE |
| Other Organization Name | CLARK AMBULANCE SERVICE |
| Practice Address |
117a Commerce Dr Dallas GA 30132 |
| Mailing Address |
Po Box 1789 Dallas GA 30132 |
| Practice Telephone | 7704452151 |
| Practice Fax Number | 7709432855 |
| Mailing Telephone | 7704455008 |
| Mailing Fax Number | 7709432855 |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2013-02-01 |
| Authorized Official Name | MR. SAMUEL T CLARK (PRESIDENT) |
| Authorized Official Telephone | 7704455008 |
| Authorized Official Credential | OWNER |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 146M00000X | Emergency Medical Technician, Intermediate | 11006 | GA | Emergency Medical Service Providers |
| N | 146N00000X | Emergency Medical Technician, Basic | 11006 | GA | Emergency Medical Service Providers |
| Y | 146L00000X | Emergency Medical Technician, Paramedic | 11006 | GA | Emergency Medical Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 00311165A | 05 | |
| GA | RAILROAD MEDICARE | 590014898 | 01 |
| Other Name | Type Code |
|---|---|
| Clark Ambulance Service | Doing Business As Name - Organization |
| Street Address |
117A COMMERCE DR |
| City | DALLAS |
| State | GA |
| Zip Code | 30132 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760462451 | Clark Ambulance Service, Inc. | Ambulance | 117a Commerce Dr, Dallas, GA 30132-5025 | 2006-01-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205398526 | Away Lice Removal Specialists, LLC | Homeopath | 531 Hardee Street, Dallas, GA 30132 | 2019-04-04 |
| 1306313184 | Jessica Ramskogler | Counselor | 168 N. Johnson St, Suite 304, Dallas, GA 30132 | 2018-10-30 |
| 1912489337 | Michelle Jennifer Bergman | Lactation Consultant, Non-RN | 549 Waburn Walk, Dallas, GA 30132 | 2018-09-01 |
| 1457870099 | Dynamic Xray Solutions LLC | Clinic/Center | 77 Wellsey Way, Dallas, GA 30132 | 2017-09-14 |
| 1528438413 | Georgia Dental Professionals, PC | Dentist | 8709 Dallas Acworth Hwy, Dallas, GA 30132 | 2015-10-05 |
| 1013256130 | Paulding Auto Sales | Private Vehicle | 210 E Memorial Dr, Dallas, GA 30132 | 2013-02-08 |
| 1255613410 | Matthew Lerandal Talley | Chiropractor | 1305 Cedarcrest Road Suite#111, Dallas, GA 30132 | 2011-09-14 |
| 1003109422 | Ashlyn Drugs | Pharmacy | 1160 Old Harris Rd, Dallas, GA 30132 | 2011-05-18 |
| 1285942086 | Premier Hearing and Health Services Inc | Clinic/Center | 300 W I Parkway Ste 207, Premier Hearing and Health Services Inc, Dallas, GA 30132 | 2010-09-15 |
| 1578878963 | Karen Parris | Speech-Language Pathologist | 283 Red Hawk Way, Dallas, GA 30132 | 2010-08-10 |
| Find all providers in zip 30132 | ||||
| Taxonomy Code | 146L00000X |
| Grouping | Emergency Medical Service Providers |
| Classification | Emergency Medical Technician, Paramedic |
| An EMT, Paramedic is an individual trained and certified to perform advanced life support (ALS) in medical emergencies based on individual state boards. |
| Notes: Sources: Tabers Medical Dictionary and Florida EMS Clearing House. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639553555 | Michelle Sturdivant | Emergency Medical Technician, Paramedic | 95 Summer Lake Cv, Dallas, GA 30157-7617 | 2015-07-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477153997 | Hosie L Baugh | Emergency Medical Technician, Paramedic | 400 Rock Meadow Dr, Stone Mtn, GA 30088-1508 | 2020-10-26 |
| 1437778883 | Metro Staffing Agency, LLC | Emergency Medical Technician, Paramedic | 1109 Medical Center Dr Ste 4, Augusta, GA 30909-6641 | 2020-04-15 |
| 1841849486 | Angela Michelle Brown | Emergency Medical Technician, Paramedic | 202 Thomson Hwy Ste C, Wrens, GA 30833-1215 | 2019-09-06 |
| 1194372201 | Desmond Newkirk | Emergency Medical Technician, Paramedic | 185 Bradford Sq Ste C, Fayetteville, GA 30215-1932 | 2019-08-22 |
| 1215426705 | Andrew Butler | Emergency Medical Technician, Paramedic | 32 Twin Oaks Pl, Savannah, GA 31407-5100 | 2018-05-09 |
| 1144735051 | Michael Scott Green | Emergency Medical Technician, Paramedic | 315 Heathrow Dr, Hiram, GA 30141-2341 | 2017-12-14 |
| 1568818342 | Mark Hulsey | Emergency Medical Technician, Paramedic | 3455 Leisure Ln, Gainesville, GA 30506-3715 | 2016-05-10 |
| 1669854519 | Dennis Middlebrooks | Emergency Medical Technician, Paramedic | 2917 Valley Ridge Dr, Decatur, GA 30032-5714 | 2015-06-26 |
| 1962895946 | Courtnei Williams | Emergency Medical Technician, Paramedic | 4267 Chamblee Tucker Rd, Tucker, GA 30084 | 2015-03-14 |
| 1003209735 | Us Army | Emergency Medical Technician, Paramedic | 1790 William H Wilson Ave, Fort Stewart, GA 31314-3100 | 2015-03-04 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.