Healthcare Provider Details

I. General information

NPI: 1790533982
Provider Name (Legal Business Name): JOYFUL TRANSPORT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2024
Last Update Date: 05/11/2024
Certification Date: 05/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 BRITTON WAY
MACON GA
31216-4156
US

IV. Provider business mailing address

625 BRITTON WAY
MACON GA
31216-4156
US

V. Phone/Fax

Practice location:
  • Phone: 478-320-6013
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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 Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: MS. JOYCE BAUTE
Title or Position: OWNER
Credential:
Phone: 478-321-6013