# URGENT CARE MEDICAL TRANSPORT, CORP

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

## Provider details

- **NPI number:** 1164816336
- **Authorized official:** MRS. ASHLEY NICOLE WILSON (OWNER)
- **Authorized official phone:** (904) 415-9427

## Contact information

- **Practice address:** 2442 STONE MOUNTAIN LITHONIA RD, STE E, LITHONIA, GA 30058-5247
- **Practice address phone:** (904) 415-9427
- **Mailing address:** 2442 STONE MOUNTAIN LITHONIA RD STE E, LITHONIA, GA 30058-5247
- **Mailing address phone:** (904) 415-9427

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 044-35 | GA | Yes |

## Other

- **Enumeration date:** 03/25/2015
- **Last updated:** 03/25/2015