# SUPERIOR MEDICAL TRANSPORT, LLC

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

## Provider details

- **NPI number:** 1710345756
- **Authorized official:** MR. FOSTER JACOBS (PRESIDENT)
- **Authorized official phone:** (678) 993-3824

## Contact information

- **Practice address:** 1256 OAKBROOK DR STE C, NORCROSS, GA 30093-2247
- **Practice address phone:** (678) 866-1467
- **Practice address fax:** (678) 325-5601
- **Mailing address:** PO BOX 2862, LILBURN, GA 30048-2862
- **Mailing address phone:** (678) 993-3824
- **Mailing address fax:** (678) 325-5601

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | AMB2017029 | GA | Yes |
| 343900000X | Non-emergency Medical Transport (VAN) | 2016000074 | GA | — |

## Other

- **Enumeration date:** 02/04/2016
- **Last updated:** 02/15/2018