# MED-TRAK LLC

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

## Provider details

- **NPI number:** 1689286866
- **Authorized official:** THOMAS FIELDS (CEO)
- **Authorized official phone:** (770) 875-8461

## Contact information

- **Practice address:** 2395 WALL ST SE STE 195, CONYERS, GA 30013-6703
- **Practice address phone:** (770) 875-8461
- **Mailing address:** 5672 SAINT THOMAS DR, LITHONIA, GA 30058-7809
- **Mailing address phone:** (770) 875-8461

## Taxonomy

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

## Other

- **Enumeration date:** 08/19/2020
- **Last updated:** 08/19/2020