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General NPI Number Information
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NPI Number | 1356929525
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Entity Type | Organization
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Legal Business Name | QUICKCARE TRANSPORT LLC
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Dates
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Enumeration Date | 03/30/2021
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Last Update Date | 04/03/2021
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Provider Practice Location Address
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Address Line | 5509 WILD CHERRY DR SW
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City | MABLETON
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State | GA
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Zip | 30126-3032
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Country | US
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Telephone | 678-754-7476
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Fax |
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Provider Business Mailing Address
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Address Line | 5509 WILD CHERRY DR SW
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City | MABLETON
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State | GA
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Zip | 30126-3032
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Country | US
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Telephone | 678-754-7476
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | GRAYLIN SAPP
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Credential | EMT-I
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Telephone | 678-754-7476
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343800000X
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Taxonomy Name | Secured Medical Transport (VAN)
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License Number |
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License Number State |
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