Healthcare Provider Details

I. General information

NPI: 1962273532
Provider Name (Legal Business Name): AZALEA MEDICAL TRANSPORT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2024
Last Update Date: 08/13/2025
Certification Date: 08/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

83 N JACKSON ST
WINDER GA
30680-2146
US

IV. Provider business mailing address

PO BOX 18537
PLEASANT HILLS PA
15236-0537
US

V. Phone/Fax

Practice location:
  • Phone: 800-249-0544
  • Fax: 724-234-2796
Mailing address:
  • Phone: 800-249-0544
  • Fax: 724-234-2796

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State

VIII. Authorized Official

Name: DR. PATRICK MICHAEL MCGANN
Title or Position: OWNER
Credential: MD
Phone: 614-256-9732