# LUKE MEDICAL TRANSPORT LLC

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

## Provider details

- **NPI number:** 1295376838
- **Authorized official:** DR. VANCE ANDRE RAHAM MD (PARTNER)
- **Authorized official phone:** (765) 265-5361

## Contact information

- **Practice address:** 260 INTERNATIONAL PKWY STE 132, DALLAS, GA 30157-5706
- **Practice address phone:** (765) 265-5361
- **Practice address fax:** (678) 567-7922
- **Mailing address:** 750 MIMMS CT NW, MARIETTA, GA 30064-6227
- **Mailing address phone:** (765) 265-5361
- **Mailing address fax:** (678) 567-7922

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 341600000X | Ambulance | — | NULL | — |
| 3416L0300X | Land Ambulance | — | NULL | Yes |

## Other

- **Enumeration date:** 10/04/2019
- **Last updated:** 03/27/2020