MEDICARE: QUALITY CARE MEDICAL TRANSPORTATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1104590678
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	QUALITY CARE MEDICAL TRANSPORTATION

Provider Business Mailing Address
First Line	:	2361 GLYNN DR SE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30316-3451
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2488 LAKEWOOD AVE SW
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30315-6326
Country	:	US
Telephone Number	:	404-923-0346
Fax Number	:

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	HENRY F REED III
Credential	:	EMT
Telephone Number	:	404-923-0346

Provider Enumeration Date	:	08/06/2021
Last Update Date	:	08/06/2021

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