Healthcare Provider Details

I. General information

NPI: 1194950790
Provider Name (Legal Business Name): PF TRANSPORT SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2009
Last Update Date: 05/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4485 TENCH RD STE 131
SUWANEE GA
30024-6739
US

IV. Provider business mailing address

6050 PEACHTREE PKWY STE 240-171
NORCROSS GA
30092-3336
US

V. Phone/Fax

Practice location:
  • Phone: 678-240-4570
  • Fax: 770-963-4415
Mailing address:
  • Phone: 678-240-4570
  • Fax: 770-963-4415

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License NumberIE028212
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code344600000X
TaxonomyTaxi
License NumberIE028212
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License NumberIE028212
License Number StateGA

VIII. Authorized Official

Name: MR. FERNANDO JEREMIAS CACERES
Title or Position: CEO
Credential:
Phone: 678-240-4570