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General NPI Number Information
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NPI Number | 1366914509
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Entity Type | Organization
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Legal Business Name | PRIMECARE MOBILITY LLC
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Dates
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Enumeration Date | 12/28/2018
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Last Update Date | 02/11/2019
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Provider Practice Location Address
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Address Line | 116 NIX POINT RD
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City | DAWSONVILLE
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State | GA
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Zip | 30534-7143
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Country | US
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Telephone | 404-242-5796
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Fax | 770-206-2381
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Provider Business Mailing Address
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Address Line | 116 NIX POINT RD
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City | DAWSONVILLE
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State | GA
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Zip | 30534-7143
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Country | US
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Telephone | 404-242-5796
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Fax | 770-206-2381
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Authorized Official
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Title or Position | PARTNER
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Name | BRIAN DANIEL CALKINS
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Credential |
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Telephone | 404-242-5796
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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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