Healthcare Provider Details

I. General information

NPI: 1285088294
Provider Name (Legal Business Name): ZA TRANSPORT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2016
Last Update Date: 06/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5061 MEMORIAL DR
STONE MOUNTAIN GA
30083-3108
US

IV. Provider business mailing address

5061 MEMORIAL DR
STONE MOUNTAIN GA
30083-3108
US

V. Phone/Fax

Practice location:
  • Phone: 404-480-4206
  • Fax: 404-909-8180
Mailing address:
  • Phone: 404-480-4206
  • Fax: 404-909-8180

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: NEMO MOHAMED
Title or Position: PRESIDENT
Credential:
Phone: 404-480-4206