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General NPI Number Information
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NPI Number | 1265803019
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Entity Type | Organization
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Legal Business Name | IMETAK LLC
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Dates
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Enumeration Date | 10/19/2015
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Last Update Date | 10/19/2015
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Provider Practice Location Address
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Address Line | 5610 GLENRIDGE DR APT 125
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City | ATLANTA
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State | GA
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Zip | 30342-1424
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Country | US
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Telephone | 678-361-5724
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Fax |
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Provider Business Mailing Address
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Address Line | 2997 COBB PKWY STE 300-723667
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City | ATLANTA
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State | GA
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Zip | 31139
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Country | US
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Telephone | 678-361-5724
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | TEMITOPE M AKINYELE
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Credential |
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Telephone | 678-361-5724
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number |
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License Number State |
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