# PROMED TRANSPORT LLC

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

## Provider details

- **NPI number:** 1285192781
- **Authorized official:** ANITA L DAVOL (MANAGER MEMBER)
- **Authorized official phone:** (727) 667-0436

## Contact information

- **Practice address:** 1720 LEXINGTON RD STE B, ATHENS, GA 30605-2330
- **Practice address phone:** (770) 800-8007
- **Practice address fax:** (770) 800-8004
- **Mailing address:** 182 ROOSEVELT BLVD, COMMERCE, GA 30529-2131
- **Mailing address phone:** (727) 667-0436
- **Mailing address fax:** (770) 814-0212

## Taxonomy

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

## Other

- **Enumeration date:** 03/04/2019
- **Last updated:** 06/06/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1497298905 | BILLING | GA |