MEDICARE: RALLYING POINT TRUCKING LLC

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	:	1225344757
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RALLYING POINT TRUCKING LLC

Provider Business Mailing Address
First Line	:	8064 S FULTON PKWY APT 1022
Second Line	:
City	:	FAIRBURN
State	:	GA
Zip	:	30213-3077
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8064 S FULTON PKWY APT 1022
Second Line	:
City	:	FAIRBURN
State	:	GA
Zip	:	30213-3077
Country	:	US
Telephone Number	:	404-519-1577
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	VIVIA COLLINS
Credential	:
Telephone Number	:	404-519-1577

Provider Enumeration Date	:	08/21/2010
Last Update Date	:	11/01/2011

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