Healthcare Provider Details

I. General information

NPI: 1306355177
Provider Name (Legal Business Name): SURE CARE MEDICAL TRANSPORTATION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2017
Last Update Date: 09/25/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 WOODCREST CIRCLE A
WARNER ROBINS GA
31093-0211
US

IV. Provider business mailing address

211 WOODCREST CIRCLE A
WARNER ROBINS GA
31093-0211
US

V. Phone/Fax

Practice location:
  • Phone: 770-572-7751
  • Fax:
Mailing address:
  • Phone: 770-572-7751
  • 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. SANDRA FOUNTAIN BUTLER
Title or Position: OFFICE MANAGER
Credential:
Phone: 770-572-7751