Organization
CITY OF ANGELS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DENISE VERNALL CLARK (OWNER)
(706) 283-5837
Entity
Organization
Contact information
Practice address
258 S THOMAS STREET, ELBERTON, GA 30635-0000
(706) 283-5837
Mailing address
258 S THOMAS STREET, ELBERTON, GA 30635
(706) 283-5837
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
EU922
GA
347C00000X
Private Vehicle
Primary
EU922
GA
Other
Enumeration date
02/22/2008
Last updated
02/22/2008
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