Healthcare Provider Details

I. General information

NPI: 1265145569
Provider Name (Legal Business Name): PINK HEARTS TRANSPORTATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2023
Last Update Date: 01/02/2023
Certification Date: 01/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

271 ROSWELL ST NE
MARIETTA GA
30060-2063
US

IV. Provider business mailing address

214 N BECKMAN CT
DALLAS GA
30132-0417
US

V. Phone/Fax

Practice location:
  • Phone: 404-850-1030
  • Fax:
Mailing address:
  • Phone: 404-825-0770
  • Fax: 404-829-1228

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code343800000X
TaxonomySecured Medical Transport (VAN)
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code342000000X
TaxonomyTransportation Network Company
License Number
License Number StateNULL

VIII. Authorized Official

Name: SHARONDA R WALKER
Title or Position: OWNER
Credential:
Phone: 404-850-1030