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General NPI Number Information
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NPI Number | 1811227820
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Entity Type | Organization
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Legal Business Name | SANACO
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Dates
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Enumeration Date | 01/14/2010
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Last Update Date | 01/14/2010
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Provider Practice Location Address
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Address Line | 2415 CREEKSIDE TRCE
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City | JONESBORO
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State | GA
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Zip | 30236-6187
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Country | US
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Telephone | 770-471-4778
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Fax |
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Provider Business Mailing Address
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Address Line | 2415 CREEKSIDE TRCE
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City | JONESBORO
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State | GA
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Zip | 30236-6187
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | SHANECE BELVIN
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Credential |
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Telephone | 770-477-4778
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 347E00000X
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Taxonomy Name | Transportation Broker
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License Number | 053867095
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number | 053867095
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License Number State | GA
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