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General NPI Number Information
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NPI Number | 1669018461
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Entity Type | Organization
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Legal Business Name | PRO MEDICAL TRANSPORT LLC
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Dates
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Enumeration Date | 11/27/2019
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Last Update Date | 03/23/2020
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Provider Practice Location Address
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Address Line | 862 BAILEY RD
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City | YOUNG HARRIS
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State | GA
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Zip | 30582-3167
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Country | US
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Telephone | 706-379-3442
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Fax |
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Provider Business Mailing Address
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Address Line | 862 BAILEY RD
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City | YOUNG HARRIS
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State | GA
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Zip | 30582-3167
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Country | US
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Telephone | 706-379-2442
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Fax |
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Authorized Official
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Title or Position | COO
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Name | GAIL BAILEY
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Credential |
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Telephone | 706-379-2442
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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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