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General NPI Number Information
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NPI Number | 1053739847
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Entity Type | Organization
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Legal Business Name | TOTAL GLORY INC
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Dates
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Enumeration Date | 03/31/2014
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Last Update Date | 03/31/2014
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Provider Practice Location Address
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Address Line | 1572 HIGHWAY 85 N STE 313
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City | FAYETTEVILLE
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State | GA
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Zip | 30214-7727
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Country | US
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Telephone | 770-629-4390
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Fax | 770-629-4390
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Provider Business Mailing Address
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Address Line | 1572 HIGHWAY 85 N STE 313
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City | FAYETTEVILLE
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State | GA
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Zip | 30214-7727
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Country | US
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Telephone | 770-629-4390
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Fax | 770-629-4390
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Authorized Official
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Title or Position | PASTOR
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Name | MS. VERCILDA JOYCE BROWN
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Credential |
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Telephone | 770-629-4390
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 347E00000X
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Taxonomy Name | Transportation Broker
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License Number | 050842390
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License Number State | GA
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