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General NPI Number Information
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NPI Number | 1699658484
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Entity Type | Organization
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Legal Business Name | ULTIMATE MEDICAL TRANSPORT LLC
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Dates
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Enumeration Date | 07/29/2025
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Last Update Date | 07/29/2025
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Provider Practice Location Address
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Address Line | 5026 SNAPFINGER WOODS DR
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City | DECATUR
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State | GA
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Zip | 30035-4063
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Country | US
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Telephone | 678-622-2538
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Fax |
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Provider Business Mailing Address
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Address Line | 2605 KINNETT DR SW
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City | LILBURN
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State | GA
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Zip | 30047-5709
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Country | US
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Telephone | 678-622-2538
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KEREN ROGERS
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Credential |
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Telephone | 678-860-4253
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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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