# GRACE CARE AMBULANCE TRANSPORT, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003321662
- **Authorized official:** MR. CARLTON THEODORE ANTHONY (OWNER)
- **Authorized official phone:** (404) 585-4857

## Contact information

- **Practice address:** 2372 S STONE MOUNTAIN RD., STE D, LITHONIA, GA 30058
- **Practice address phone:** (404) 585-4857
- **Practice address fax:** (404) 521-4686
- **Mailing address:** 2372 S STONE MOUNTAIN RD, SUITE D, LITHONIA, GA 30058
- **Mailing address phone:** (404) 585-4857
- **Mailing address fax:** (404) 393-4041

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | — | NULL | Yes |

## Other

- **Enumeration date:** 12/05/2017
- **Last updated:** 05/28/2025