Healthcare Provider Details

I. General information

NPI: 1568297679
Provider Name (Legal Business Name): VIGOR NEMT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2024
Last Update Date: 09/06/2024
Certification Date: 09/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 W PEACHTREE ST NW STE 2300
ATLANTA GA
30309-3453
US

IV. Provider business mailing address

1201 W PEACHTREE ST NW STE 2300
ATLANTA GA
30309-3453
US

V. Phone/Fax

Practice location:
  • Phone: 470-569-2158
  • Fax:
Mailing address:
  • Phone: 470-569-2158
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343800000X
TaxonomySecured Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MEYENDO SCOTT
Title or Position: CEO
Credential:
Phone: 470-569-2158