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General NPI Number Information
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NPI Number | 1578071395
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Entity Type | Organization
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Legal Business Name | CORE CARE MEDICAL TRANSPORT, LLC
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Dates
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Enumeration Date | 01/15/2018
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Last Update Date | 01/17/2024
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Provider Practice Location Address
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Address Line | 1316 LAKEWOOD AVE SE # G-4
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City | ATLANTA
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State | GA
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Zip | 30315-2313
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Country | US
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Telephone | 678-372-1493
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Fax | 770-776-9956
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Provider Business Mailing Address
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Address Line | 2611 WELLINGTON DR
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City | ALBANY
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State | GA
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Zip | 31721-1549
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Country | US
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Telephone | 678-372-1493
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | VICTORIA MEADOWS
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Credential |
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Telephone | 770-776-9956
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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 | GA
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