Healthcare Provider Details

I. General information

NPI: 1912349200
Provider Name (Legal Business Name): AGAPE MEDICAL TRANSPORT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2013
Last Update Date: 07/31/2024
Certification Date: 07/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3706 MERCER UNIVERSITY DR STE 32
MACON GA
31204-4889
US

IV. Provider business mailing address

4017 LIBERTY ESTATES DR
MACON GA
31216-6637
US

V. Phone/Fax

Practice location:
  • Phone: 478-972-1891
  • Fax: 478-254-2838
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: DONNIE ANTONIO HAMMONDS
Title or Position: OWNER
Credential:
Phone: 478-342-5784