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General NPI Number Information
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NPI Number | 1235472044
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Entity Type | Organization
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Legal Business Name | ATL ELDERLY TRANSPORTATION LLC
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Dates
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Enumeration Date | 03/29/2013
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Last Update Date | 03/29/2013
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Provider Practice Location Address
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Address Line | 8140 WEBB ROAD 504
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City | RIVERDALE
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State | GA
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Zip | 30274-6533
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Country | US
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Telephone | 877-528-6855
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Fax | 877-414-3647
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Provider Business Mailing Address
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Address Line | PO BOX 143546
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City | FAYETTEVILLE
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State | GA
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Zip | 30214-6533
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Country | US
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Telephone | 877-528-6855
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Fax | 877-414-3647
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Authorized Official
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Title or Position | MANAGER
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Name | MR. ERIC ARKOMAH
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Credential |
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Telephone | 678-510-9827
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number | 056358716
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License Number State | GA
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