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General NPI Number Information
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NPI Number | 1508292293
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Entity Type | Organization
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Legal Business Name | PRIORITY HEALTHCARE TRANSPORTATION LLC
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Dates
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Enumeration Date | 09/25/2013
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Last Update Date | 09/25/2013
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Provider Practice Location Address
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Address Line | 115 PERIMETER CENTER PL NE 630
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City | ATLANTA
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State | GA
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Zip | 30346-1249
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Country | US
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Telephone | 678-768-0201
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Fax |
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Provider Business Mailing Address
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Address Line | 115 PERIMETER CENTER PLACE 630
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City | ATLANTA
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State | GA
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Zip | 30346
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Country | US
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Telephone | 678-768-0201
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | MS. SHAREDA L WARD
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Credential |
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Telephone | 678-768-0201
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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 | 051349337
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License Number State | GA
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