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General NPI Number Information
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NPI Number | 1508237421
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Entity Type | Organization
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Legal Business Name | ENVISION CARE LLC
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Dates
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Enumeration Date | 10/19/2015
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Last Update Date | 10/19/2015
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Provider Practice Location Address
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Address Line | 4267 CHAMBLEE TUCKER RD
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City | DORAVILLE
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State | GA
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Zip | 30340-4501
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Country | US
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Telephone | 678-670-6578
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Fax |
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Provider Business Mailing Address
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Address Line | 4267 CHAMBLEE TUCKER RD
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City | DORAVILLE
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State | GA
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Zip | 30340-4501
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. GREELENSKY CHARLES
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Credential |
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Telephone | 678-670-6578
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number |
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License Number State |
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Taxonomy #2
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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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Taxonomy #3
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number |
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License Number State |
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