MEDICARE: ALTRUISTIC TRANSPORTATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	347C00000X	Private Vehicle

General Provider Information

NPI Number	:	1487472163
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALTRUISTIC TRANSPORTATION

Provider Business Mailing Address
First Line	:	2875 LAKEWOOD AVE SW
Second Line	:	STE A5 #3004
City	:	ATLANTA
State	:	GA
Zip	:	30315
Country	:	US
Telephone Number	:	678-536-3818
Fax Number	:

Provider Business Practice Location Address
First Line	:	2875 LAKEWOOD AVE SW
Second Line	:	STE A5 #3004
City	:	ATLANTA
State	:	GA
Zip	:	30315
Country	:	US
Telephone Number	:	678-536-3818
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	TABITHA ANDREAL WEEMS
Credential	:
Telephone Number	:	770-624-6031

Provider Enumeration Date	:	10/01/2024
Last Update Date	:	10/23/2024

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