=====================================================
General NPI Number Information
=====================================================
NPI Number | 1285218842
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TRANSAFETY CONSULTANT LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/10/2021
-----------------------------------------------------
Last Update Date | 08/02/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7754 HAMPTON PL
-----------------------------------------------------
City | LOGANVILLE
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30052-6770
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 470-709-4142
-----------------------------------------------------
Fax | 678-694-8286
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7754 HAMPTON PL
-----------------------------------------------------
City | LOGANVILLE
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30052-6770
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 470-709-4142
-----------------------------------------------------
Fax | 678-694-8286
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MR. WENDELL D STAFFORD
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 470-709-4142
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 343900000X
-----------------------------------------------------
Taxonomy Name | Non-emergency Medical Transport (VAN)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------