Organization
PROMED TRANSPORT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANITA L DAVOL (MANAGER MEMBER)
(727) 667-0436
Entity
Organization
Contact information
Practice address
1720 LEXINGTON RD STE B, ATHENS, GA 30605-2330
(770) 800-8007
(770) 800-8004
Mailing address
182 ROOSEVELT BLVD, COMMERCE, GA 30529-2131
(727) 667-0436
(770) 814-0212
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1497298905
BILLING
GA
Enumeration date
03/04/2019
Last updated
06/06/2023
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