Organization
DIVINE NET TRANSPORTATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSEPH LEE SHANKS (CEO/OWNER)
(706) 631-5258
Entity
Organization
Contact information
Practice address
3114 AUGUSTA TECH DR, SUITE 105, AUGUSTA, GA 30906
(706) 792-2628
(706) 792-2799
Mailing address
3114 AUGUSTA TECH DR, SUITE 105, AUGUSTA, GA 30906
(706) 792-2628
(706) 792-2799
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
LCB20120000712
GA
Other
Enumeration date
10/02/2013
Last updated
10/02/2013
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