=====================================================
General NPI Number Information
=====================================================
NPI Number | 1275461105
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CARLOS STONE
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/11/2026
-----------------------------------------------------
Last Update Date | 05/11/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2494 GA HIGHWAY 102
-----------------------------------------------------
City | WARTHEN
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 31094-3616
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 478-232-9032
-----------------------------------------------------
Fax | 478-666-6030
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2494 GA HIGHWAY 102
-----------------------------------------------------
City | WARTHEN
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 31094-3616
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 478-232-9032
-----------------------------------------------------
Fax | 478-666-6030
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 343900000X
-----------------------------------------------------
Taxonomy Name | Non-emergency Medical Transport (VAN)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------