Healthcare Provider Details

I. General information

NPI: 1891538716
Provider Name (Legal Business Name): AS ONE TRANSPORT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2024
Last Update Date: 09/18/2024
Certification Date: 09/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

317 HARLEY FARMS DR
BONAIRE GA
31005-5634
US

IV. Provider business mailing address

317 HARLEY FARMS DR
BONAIRE GA
31005-5634
US

V. Phone/Fax

Practice location:
  • Phone: 478-455-7886
  • Fax:
Mailing address:
  • Phone: 478-455-7886
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QA0005X
TaxonomyAmbulatory Family Planning Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QE0002X
TaxonomyEmergency Care Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code333300000X
TaxonomyEmergency Response System Companies
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: DEMETRIUS MOYE
Title or Position: CEO
Credential:
Phone: 478-455-7886