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General NPI Number Information
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NPI Number | 1477839538
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Entity Type | Organization
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Legal Business Name | SHEPHERD'S MEDICAL TRANSPORTATION SERVICES,LLC
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Dates
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Enumeration Date | 11/02/2011
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Last Update Date | 11/02/2011
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Provider Practice Location Address
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Address Line | 4641 ASH TREE ST
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City | SNELLVILLE
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State | GA
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Zip | 30039-3359
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Country | US
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Telephone | 404-835-7690
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1142
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City | LOGANVILLE
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State | GA
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Zip | 30052-1142
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Country | US
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Telephone | 404-835-7690
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Fax |
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Authorized Official
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Title or Position | OPERATION MANAGER
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Name | ZENDRA S SHEPHERD
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Credential |
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Telephone | 404-835-7690
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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 | GA
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