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General NPI Number Information
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NPI Number | 1508760505
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Entity Type | Organization
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Legal Business Name | VICTORIOUS MEDICAL MOBILITY, LLC
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Dates
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Enumeration Date | 10/05/2026
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Last Update Date | 10/05/2026
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Provider Practice Location Address
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Address Line | 12012 MIDDLEGROUND RD APT C101
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City | SAVANNAH
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State | GA
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Zip | 31419-3655
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Country | US
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Telephone | 912-547-8223
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Fax |
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Provider Business Mailing Address
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Address Line | 12012 MIDDLEGROUND RD APT C101
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City | SAVANNAH
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State | GA
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Zip | 31419-3655
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Country | US
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Telephone | 912-547-8223
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KATRINA MACHELLE GARVIN
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Credential | NEMT
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Telephone | 912-547-8223
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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 | NULL
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