Healthcare Provider Details

I. General information

NPI: 1669748471
Provider Name (Legal Business Name): PRECIOUS CARGO TRANSPORTATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2012
Last Update Date: 03/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4506 YATES RD
COLLEGE PARK GA
30337-5212
US

IV. Provider business mailing address

PO BOX 1327
RED OAK GA
30272-1327
US

V. Phone/Fax

Practice location:
  • Phone: 404-925-4706
  • Fax: 404-478-8489
Mailing address:
  • Phone: 404-925-4706
  • Fax: 404-478-8489

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number
License Number State

VIII. Authorized Official

Name: MS. VANESSA OLIVER WILLIAMS
Title or Position: PRESIDENT
Credential:
Phone: 404-925-4706