Healthcare Provider Details

I. General information

NPI: 1194643692
Provider Name (Legal Business Name): PROSPERITY HEALTH TRANSPORT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2026
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5211 PEACHTREE BLVD
ATLANTA GA
30341-3165
US

IV. Provider business mailing address

5211 PEACHTREE BLVD
ATLANTA GA
30341-3165
US

V. Phone/Fax

Practice location:
  • Phone: 856-739-4463
  • Fax: 856-739-4463
Mailing address:
  • Phone: 856-739-4463
  • Fax: 856-739-4463

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: DR. STEFANO STEFANO OSUJI
Title or Position: CEO
Credential: PHD
Phone: 856-739-4463