# LIFEPOINTE MEDICAL TRANSPORT LLC

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

## Provider details

- **NPI number:** 1134531684
- **Authorized official:** MR. CHARLES ALEXANDER KEMP II M.B.A. (MEMBER)
- **Authorized official phone:** (229) 402-1411

## Contact information

- **Practice address:** 4191 GRAY HWY, GRAY, GA 31032-6101
- **Practice address phone:** (229) 402-1411
- **Practice address fax:** (478) 216-2015
- **Mailing address:** PO BOX 1654, GRAY, GA 31032-1654
- **Mailing address phone:** (229) 402-1411
- **Mailing address fax:** (478) 216-2015

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | — | NULL | Yes |
| 343900000X | Non-emergency Medical Transport (VAN) | — | GA | — |

## Other

- **Enumeration date:** 06/02/2014
- **Last updated:** 06/02/2014